Beating heart bypass surgery, also known as CABG, is performed while the heart is still beating and is increasingly common. It is recommended for patients with severe angina, multiple artery blockages, or in emergency situations like heart attacks when other treatments are ineffective. The procedure involves grafting blood vessels to bypass blockages and has been linked to shorter recovery times and fewer complications compared to traditional methods.

1. Beating Heart Bypass Surgery –
Things You Should Know

2. Introduction
• Coronary Artery Bypass Grafting (CABG), commonly referred Bypass
Surgery, is a surgical procedure that redirects blood flow around a
blockage or narrowed section in the major arteries supplying blood
and oxygen to the heart.
• A cardiac surgeon can perform the bypass surgery in any of the 2
ways,
1. Beating Heart Bypass Surgery is CABG performed while your
heart is still beating, and does not require a heart-lung
machine. This method has become more common during the
recent times.

3. Contd.
2. The other, more traditional method of Cardiopulmonary
Bypass (CPB) uses a heart-lung machine and involves
temporarily stopping the heart and replacing it with the
machine.
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4. Heart Lung Bypass

5. When is Beating Heart Bypass
Surgery recommended?
• The heart requires a constant supply of blood and oxygen.
• The left and right coronary arteries supplying these to the heart can
develop a condition known as Atherosclerosis, in which these
arteries become narrowed due to fatty-acid build-up.
• The condition is also known as Coronary Heart Disease.
• Severe atherosclerosis interferes with the supply of oxygen-rich
blood to the heart muscles and cause chest pain, an ailment called
Angina.

6. Contd.
• A cardiac surgeon may consider a bypass surgery in the
following situations:
– Angina is severe and your heart muscles fall short of oxygen
supply with even the lightest form of activity or at rest.
– There are blockages in more than one artery supplying blood to
the heart.
– Artery blockages could not be treated with medication or
artery-opening procedures like angioplasty, or you have been
through a previously unsuccessful angioplasty.
– Emergency situations like a heart attack may prompt the CABG.
• Read about Questions to Ask Before CABG

7. Understanding Beating Heart Bypass
Surgery Procedure
1. Before the Procedure
– Your doctor will guide you through necessary medication,
restrictions on diet and changes lifestyle ahead of your surgery.
– Various pre-surgical tests like the electrocardiogram (ECG),
coronary angiogram, chest X-rays and blood tests will determine
your overall health and current status of artery blockages.
– It is a good time to ask your doctor and other members of your
healthcare team any questions or concerns you may have
regarding the procedure.

8. 2. During the Procedure
– Beating heart CABG surgery typically lasts 3 to 6 hours but may
vary depending on the severity and number of blockages in the
heart.
– The surgery is performed under the effect of a general
anaesthesia.
– The surgeon begins the procedure by removing a segment of a
healthy artery or vein (graft) from another part of your body.
– Grafts are usually taken from the leg (saphenous vein), inside
the chest (internal mammary artery) or the arm (radial artery).
– Once the graft is ready, the surgeon makes an incision in the
centre of the chest, along the breastbone, and spreads open the
rib cage to access the heart.

9. Contd.
– Unlike the CBP procedure that stops the heart temporarily and
allows circulation of blood to body through the heart-lung
machine, heart continues to beat in the beating heart CABG.
– The surgeon stabilises the area of the heart to be worked on
using a stabilisation device.
– The device gently attaches itself to the surface of the heart
through small suction pods that will steady the heart’s
movement in that area.
– Next, one end of the graft is attached to the area that lies just
above the blockage in heart artery.
– The other end is attached to an area below the blockage. Once
the graft is successfully implanted over the blocked blood
vessel, normal blood flow resumes in that portion.

10. 3. Recovery
– Depending on your response to the procedure, you will be
monitored in the intensive care unit (ICU) for a day or two post
the surgery before being transferred to regular hospital care for
some more time.
– Discharge may take place within a week, but it will take another
three to four weeks before you start feeling better and be able
to resume some of your daily activities.
– Your doctor may recommend you to attend a cardiac
rehabilitation programme for recovery through exercise and
education therapy.
– Follow-up check ups as directed by your hospital will help
monitor your progress and take note of any relapse in
treatment.
• Read more about Recovery after CABG.

11. 4. Risk
• Possible risks from a coronary bypass surgery include:
– Chest wound infection
– Heart rhythm problems or stroke
– Arrhythmias
– Post-pericardiotomy syndrome, or low fever and chest pain
– Disruption of cognitive abilities and memory loss
– Clinical studies have linked beating heart CABG procedure to
shorter post-operative stays and reduced complications after
surgery as compared to the CPB.
– A beating heart CABG surgery effectively restores blood supply
to your heart.
– However, only heart-healthy lifestyle changes will maintain the
positive, long-term results of the surgery.
• Read about Lifestyle Changes for a Healthy Heart