Open Heart Surgery/CABG/Coronary Artery Bypass Graft

Open heart surgery is any surgery in which the chest is opened and surgery is performed on the heart muscle, valves, arteries or other heart structures. The term "open" refers to the chest, not the heart itself. The heart may or may not be opened, depending on the type of surgery.

Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach the heart. It is done to fix problems caused by coronary artery disease, in which the arteries that lead to the heart are partly or totally blocked. A heart-lung machine is usually used during the surgery to provide oxygen-rich blood to the brain and other vital organs.

The definition of open-heart surgery has become confusing because of new procedures being performed on the heart through smaller incisions. Some new surgical procedures are done with the heart still beating.

The procedure involves general anesthesia so that the patient is unconscious and unable to feel pain.

The surgeon makes a 10-inch incision in the middle of the chest. The breastbone is then separated to create an opening that allows the surgeon to see the heart and aorta.

Most people who have coronary bypass surgery are connected to a heart-lung bypass machine, or bypass pump. This machine does the work of the heart while the heart is stopped for the surgery. The machine adds oxygen to the blood and circulates blood through the body.

A newer method does not use the heart-lung bypass machine. The bypass is created while the heart is still beating. This is called off-pump coronary artery bypass, or OPCAB. This method may be used for patients who could have problems caused by being on the heart-lung machine.

During this surgery, the surgeon takes a vein or artery from another part of the body and uses it to create a detour (or graft) around the blocked area in the artery.

After the graft has been created, the breastbone will be reconnected with wire, and the incision will be sewn closed. The wire will remain inside the patient.

Risks include:

  • Blood clots in the legs that may travel to the lungs
  • Breathing problems
  • Infection in the lungs, urinary tract and chest
  • Blood loss
  • Heart attack or stroke
  • Sternal (chest) wound infection, which is more likely to occur in people who are obese, have diabetes, or have already had this surgery
  • Post-pericardiotomy syndrome, which is a low-grade fever and chest pain. It could last up to six months
  • Some people report memory loss and loss of mental clarity, or "fuzzy thinking"
  • Heart rhythm problems

After the operation, the patient will spend five to seven days in the hospital. The first few hours will be in an intensive care unit (ICU). It takes four to six weeks to start feeling better after surgery.

Texas Health is committed to providing quality care to heart and vascular patients throughout North Texas and beyond. While various technologies and services are discussed here, not all of our hospitals offer every treatment and diagnostic technology highlighted. Call 1-877-THR-WELL to learn more about heart and vascular services at a Texas Health hospital near you.

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