A coronary artery bypass is one of several types of open-heart surgeries, which are major medical procedures.
Open-heart surgery is a group of procedures that involve cutting through the breastbone to access the heart. They’re major operations used to treat many heart problems.
A heart bypass is a specific type of open-heart surgery where a surgeon takes a blood vessel from another part of your body and uses it to make a new pathway around a blocked artery in your heart.
Read on to learn more about heart bypass and open-heart surgeries, including when they’re used, what happens during the procedures, and outcomes.
The purpose of bypass versus open-heart surgery
A coronary artery bypass surgery (CABG) is used to treat coronary artery disease. Coronary artery disease occurs when the major arteries in your heart become narrow from the buildup of plaque.
If your heart doesn’t receive enough oxygen, you may develop chest pain called angina . If a piece of plaque ruptures, it can completely block one of your arteries and lead to a heart attack or stroke.
An open-heart surgery is a broad term that refers to any surgery that involves spreading your ribcage to access your heart. These surgeries may be used to:
Bypass and open-heart surgery side effects and risks
Open-heart surgery — including bypass — is not without risks of complications .
Possible side effects or complications include:
- bleeding
- arrhythmia
- blood clots , which can cause stroke
- damage to your heart, kidneys, liver, or lungs
- infections
- swelling
- memory loss and other cognitive problems
- pneumonia
- death
The risk of death is generally highest for people who are very sick before their procedure. Emergency surgeries generally have higher rates of complications than planned surgeries.
How effective is bypass vs. open-heart surgery?
Bypass surgery and other types of open-heart surgery can be lifesaving. They can prevent or treat complications of heart disease, such as:
Bypass vs. open-heart surgery procedures
Here’s a general idea of what you can expect during bypass and other open-heart surgeries.
Coronary artery bypass procedure
A coronary bypass procedure usually takes 3 to 6 hours . After surgery prep, the procedure will typically go as follows:
- Your surgeon will make an incision to access and remove a blood vessel from somewhere in your chest, arm, or leg to be used as the bypass graft.
- To access the heart, they will make an incision through the skin over your breastbone and then through the bone. They will use a special tool to spread your ribs to access your heart.
- Your blood flow may be routed temporarily to an artificial heart-lung machine, and your heart stopped with a medication.
- Your surgeon will attach the new blood vessel.
- Once your graft is in place, they can restart your heart with electrical shocks, if needed.
- Your breastbone will be closed using metal wires, and your skin will be closed with stitches.
Open-heart surgery
There are several types of open-heart surgery, so the procedure will vary slightly. Here’s an example of the procedure for a heart transplant:
- Your surgeon will make an incision in your chest to access your breastbone. They will then cut through your breastbone and spread your ribs.
- Your heart will be stopped with medications and you’ll be connected to a heart-lung bypass machine to keep blood circulating through your body.
- Your surgeon will remove your heart and attach a heart from a deceased donor.
- They can then close your rib cage and seal your wounds with stitches.
What is the survival rate of bypass vs. open-heart surgery?
The success of cardiac surgery depends on many factors, such as the overall health of the person undergoing surgery, other underlying conditions, and the complexity of the surgery.
In a 2021 study , researchers found that the operative mortality of coronary artery bypass surgery was 2.2%, meaning that 2.2% of people passed away within 30 days of getting the surgery.
Preparing for bypass or open-heart surgery
Open heart procedures, including bypass procedures, are performed under general anesthesia, meaning you’ll be asleep. You won’t be able to eat or drink for hours in advance.
Your surgical team may tell you to stop taking medications or supplements that thin your blood. They will review specific guidelines with you before the surgery.
Recovering from bypass and open-heart surgery
You’ll need to stay in the hospital for about a week following a coronary bypass procedure. It may take about 12 weeks to fully recover.
Some types of heart surgeries, like a heart transplant, may take even longer to recover from.
How much does bypass and open-heart surgery cost?
The exact out-of-pocket cost of heart surgery varies and depends on where it is performed and your insurance coverage. It can be very expensive, but most surgeries are covered by insurance if they’re necessary.
Coronary artery bypass surgery can cost over $50,000 . Procedures that require multiple blood vessel grafts are often more expensive.
The average price of a heart transplant in the United States without insurance is over $1.6 million .
What is the life expectancy of a person after bypass or other open-heart surgery?
Your life expectancy after heart surgery depends on many factors, including your:
- age
- degree of heart disease
- overall health
In a 40-year study, researchers examined the long-term survival of 1,041 people with a median age of 53 who received CABG. The estimated survival time after CABG was 18 years .
The researchers reported the following survival rates for people who received coronary artery bypass surgery:
| Follow-up time | Survival rate |
|---|
| 10 years | 77% |
|---|
| 20 years | 39% |
|---|
| 30 years | 14% |
|---|
| 40 years | 4% |
|---|
Frequently asked questions about bypass and open-heart surgery
Can bypass surgery be done without opening the chest?
Doctors have developed minimally invasive alternatives to traditional coronary bypass surgery. During these procedures, they make a series of small incisions to access your heart instead of opening your rib cage.
How serious are bypass and open-heart surgery?
Coronary bypass and other forms of open-heart surgery are major surgeries. Recovery from bypass procedures can take about 12 weeks .
What are the chances of having a heart attack after bypass surgery?
CABG is used to treat coronary artery disease and can lower your risk of a heart attack later. However, all major surgeries can cause a risk of major heart complications.
Your risk of having a heart attack remains elevated for about a month after surgery.
Takeaway
A coronary artery bypass is a procedure where blood vessels are taken from another part of your body and used to create a new pathway around a blockage in arteries that supply your heart.
Open-heart surgery refers to any procedure that involves opening your ribcage to access your heart. Coronary artery bypass is the most common type of open-heart procedure.
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