How Is Heart Bypass Surgery Performed?

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We all have come across the term Heart bypass surgery at least once. It is also known as coronary artery bypass surgery and it is basically, used for the replacement of the damaged arteries responsible for supplying blood to the muscles of the heart. Blood vessels from another area of the body are taken for repairing the damaged arteries. The surgery is usually performed when the coronary arteries are damaged or blocked as these supply oxygenated blood to the heart. If these are blocked or blood flow is restricted, it can lead to heart failure.


Depending on how many arteries are blocked, there are some types of heart bypass surgery and you will undergo on the basis of the number of arteries blocked.

  • Single bypass: There is the only artery blocked.
  • Double bypass: Here, two arteries are blocked.
  • Triple bypass: In this, there are three arteries blocked.
  • Quadruple bypass: When four arteries are blocked, this surgery is done.

On the basis of the number of arteries blocked, the risk of having a heart failure, heart attack, or another cardiac issue depends. If there are more arteries blocked, it also means that the surgery can be long and become more complex.


There is a material in the blood known as plaque. When this plaque starts building up on the arterial walls, it makes arteries narrow, making the blood passage to the heart muscles less and difficult. Then, the heart muscle is more likely to get exhausted and fail. Most often, the left ventricle is affected which is the primary pump of the heart. The condition is known as atherosclerosis or coronary artery disease. The heart bypass surgery is recommended when the blockage of the arteries is too severe that it can’t be managed with other treatments.



Before the surgery, medications, fluids, and anesthesia are what you are given through an intravenous (IV). When the anesthesia starts working, you will fall asleep.


First of all, an incision is made in the middle of the chest. The heart is placed inside rib cage for the protection. That is why; the rib cage is spread apart so that the heart can be exposed. Or maybe, a minimally invasive surgery can opt too. In this, smaller cuts are involved and special miniaturized instruments are used with the robotic procedures. After this, the patient is hooked up to a cardiopulmonary bypass machine. It is also called heart-lung machine and it basically circulates the oxygenated blood through the body while the surgeons operate on the heart.

The blood is pumped out of the heart by the machine so as to remove the carbon dioxide, and the machine is filled with the oxygen then. The oxygenated blood is then pumped back into the body without making it go through the lungs and the heart. This keeps the oxygenated blood pumping through the whole body so that no complications are faced. There are some procedures performed “off-pump”, which means that connecting you to the heart-lung machine is not necessary.

There are some cooling techniques used, sometimes known as extreme cooling so that the body temperature of the patient can be brought down to around 64.4 degrees Fahrenheit (18 degrees Celsius). This technique actually suspends the processes of the body and makes the long heart surgeries to take place without any trouble. The heart needs less oxygen when the body is at low temperature. The heart is cooled down with the help of the heart-lung machine or by dousing the heart with salty, cold water. The heart tissues can be operated for a few hours at a time by using the cooling techniques as these techniques decrease the risk of brain damage or heart damage from the lack of oxygen.

A healthy blood vessel is then removed from inside the chest wall or leg to replace the damaged or blocked portion of the artery. One end of the graft is attached above the blockage and the other one is attached below it. When it is done, the heart-lung machine is removed and the function of the bypass is properly checked. Once it is confirmed that the bypass is working. The patient is stitched up, bandaged and taken to the ICU (Intensive Care Unit) for monitoring.

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