If you’ve been diagnosed with coronary artery disease (CAD), the arteries that supply blood to your heart have become hardened and narrowed. These changes are due to a buildup of plaque, a combination of cholesterol, calcium and other materials. Plaque can build up, causing blockages that slow blood flow to the heart and increasing risk for a heart attack.
Your doctor may recommend coronary artery bypass surgery (bypass surgery) depending on the number, location and type of blockage. Some patients have emergency bypass surgery after blockages stop blood from reaching the heart, causing a heart attack. Bypass surgery is a procedure to reroute blood around the blockages, restoring blood flow to the heart.
“Bypass surgery has been a safe, effective and durable treatment for coronary artery disease for more than 50 years. After a three-month recovery period, you can return to your normal activities. You’ll feel better too. If you commit to ongoing follow-up care and healthy habits, you can enjoy an active life for decades to come,” says Vincent Simonetti, M.D., a cardiothoracic surgeon at Henry Ford Health.
Here Dr. Simonetti explains how bypass surgery treats CAD and what to expect during your hospital stay and recovery.
How Bypass Surgery Restores Blood Flow To The Heart
There is no cure for CAD, but there are several treatments to prevent its progression. In its early stages, CAD can be treated with medications and lifestyle changes.
If the disease progresses, blockages in one or two arteries may be treated with angioplasty. With this procedure, your cardiologist carefully threads a thin tube called a catheter into your coronary arteries. The catheter has a deflated balloon-shaped device at the end. Once the catheter reaches the blockage, your doctor inflates the balloon to push the plaque flat and widen the artery. Your doctor may also place a mesh coil called a stent to keep the artery open.
With more severe blockages, bypass surgery is the best treatment option. It offers patients the best outcomes when:
- There are blockages in more than two or three arteries.
- Blockages are in areas that are difficult to reach and treat with angioplasty.
- There are blockages too severe to be treated with angioplasty.
What To Expect On The Day Of Bypass Surgery
On the day of surgery, you’ll check in to the hospital early in the morning. Your care team prepares you for the procedure, inserting intravenous (IV) lines to give you medication. An anesthesiologist gives you medication to put you to sleep.
During bypass surgery, a cardiothoracic surgeon removes a small portion of a blood vessel from elsewhere on your body. After making a vertical incision in your chest, the surgeon attaches the healthy blood vessel called a graft on either side of the blockage. The graft creates a new pathway, bypassing the blockage and rerouting blood flow to the heart.
A heart-lung machine performs the functions normally done by your heart during the operation. This allows the surgeon to stop the heart from beating while building the bypasses. The machine adds oxygen to your blood and pumps it through the body to preserve your other organs.
Bypass surgery takes about four to five hours, depending on many individual factors of the specific operation.
Your Hospital Stay After Bypass Surgery
After surgery, you recover in the cardiac intensive care unit (CICU) for two to three days. You can expect to stay in the hospital for up to a week after surgery.
In the days following surgery, you may have pain from your chest incision. Some patients also experience shortness of breath, nausea or difficulty sleeping. Medications can help manage these symptoms, which lessen over time.
While you’re in the hospital, your care team helps you get up and move around. Physical and occupational therapists prepare you for the transition home. You’ll learn how to move through daily tasks without straining your chest muscles.
Recovery And Heart Health Following Bypass Surgery
After surgery, your next steps are to take time for recovery and maintain your heart health going forward. For the best long-term outcome after bypass surgery, Dr. Simonetti advises patients to:
- Take all prescribed medications: Continue taking aspirin and statins or other medications to reduce the risk for future blockages. Keep diabetes and high blood pressure (hypertension) under control with medications and diet.
- Avoid heavy lifting: During bypass surgery, the surgeon accesses your heart through an incision in your chest bone (sternum). After surgery, avoid lifting anything over ten pounds for six weeks to give your chest bone time to heal.
- Complete cardiac rehabilitation: Once you leave the hospital, your doctor will recommend a cardiac rehabilitation program. The goal of the program is to restore your physical and emotional health through education and exercise. Through either an at-home or on-site program, you’ll regain your physical stamina through closely monitored exercise sessions for up to three months.
- See your doctor regularly: You should have ongoing care from a primary care physician and cardiologist. With periodic testing, your care team can monitor your heart function and identify and treat new blockages. Be an active partner in your care by knowing your numbers, such as your blood pressure, cholesterol level, weight and body mass index.
- Adopt a healthy lifestyle: You’re never too old to make lifestyle changes to improve your heart health. Commit to eating a heart healthy diet, avoiding foods high in sodium and saturated fat. Get moving with regular exercise and stop smoking. Use a stress tracker to help manage your emotions. Adopt habits to get a good night’s sleep.
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To learn more about coronary artery disease or to find a heart surgeon, visit henryford.com/heart or call 844-725-6424 for Detroit and Southeast Michigan patients or 517-205-7605 for Jackson or South Central patients.
Dr. Vincent Simonetti is a cardiothoracic surgeon who sees patients at Henry Ford Jackson Hospital.
