Triple Bypass Surgery

What is triple bypass surgery?

Triple bypass surgery reroutes blood around three blocked areas in your

coronary (heart) arteries

. A surgeon moves blood vessels from elsewhere in your body to your heart. This allows blood to flow through open blood vessels instead of trying to move through blocked ones.

 

You may hear people refer to this surgery as a

coronary artery bypass graft

or CABG. It’s usually an

open-heart surgery

.

 

Can triple bypass surgery be minimally invasive?

Yes, but in very select scenarios. Some people meet the criteria for a triple bypass surgery that requires only a 3-inch cut between their ribs. Others can have a robotically assisted operation that uses a few 2-inch cuts. However, these

minimally invasive techniques

aren’t a good option for everyone and are only suitable for highly select people. These procedures typically don’t use a

heart-lung machine

, which means your heart keeps beating during the surgery. A provider can tell you which method is best for your situation.

 

Who needs to have triple bypass heart surgery?

People who have

coronary artery disease

may need triple bypass surgery. It’s most likely the best option for people with plaque (made up of fats and cholesterol) in three parts of their heart’s arteries. They need this operation because they have plaque blockages in their arteries that supply blood to their heart muscle. These blockages can cause chest pain, shortness of breath and heart attacks.

 

Why is triple bypass surgery done?

People need triple bypass surgery because:

• They have 50% or more blockage in their left main vessel or 70% or more blockage in branch coronary arteries.
• A less invasive method (

  angioplasty

  ) didn’t work or a provider didn’t recommend it because of the severity and complexity of the blockages.

How common is triple bypass surgery?

Coronary artery bypass grafting (CABG) is one of the most common major surgeries. It can treat one or more blocked arteries in your heart. Triple bypass surgery is a type of CABG that involves three blocked areas.

Worldwide, an estimated 44 people per 100,000 have a bypass surgery. In the United States, 79 people per 100,000 have the surgery.

What happens before triple bypass heart surgery?

A healthcare provider will order tests to complete before the day of surgery. These may include:

• Angiogram

  .
• Chest X-ray or a

  CT scan

  of your chest.
• Blood tests.

• Echocardiogram

  .

• Electrocardiogram (EKG)

  .

• Ultrasound of your carotid artery

  .

A provider will ask you to stop eating and drinking at midnight before your surgery. You’ll also need to temporarily stop taking certain medicines for several days before your operation.

On the day of your surgery, you’ll change into a hospital gown and leave your belongings with a family member. You’ll get an IV for medication that will put you to sleep for the surgery. You’ll receive a breathing tube as well.

What happens during triple bypass surgery?

While you’re under

general anesthesia

, a surgeon will:

 

• Make an approximately 6-inch vertical cut down the middle of your chest (for open-heart surgery).
• Split your breastbone down the middle to get to your heart.
• Remove a blood vessel from your leg, arm or chest.
• Attach one end of the blood vessel to your

  aorta

  and the other to your coronary artery (below the blocked part). If they use an artery that’s under your collarbone, they may leave that part connected and attach the other end to your heart. They may need to do this in several places, depending on where the blockages are located.

How long does triple bypass surgery take?

Triple bypass surgery can take three to six hours.

What happens after triple bypass surgery?

You’ll have a breathing tube that goes into your mouth and throat. Most likely, you’ll only have this for up to 12 hours. Machines will keep checking your heart rate and blood pressure. You may have other tubes that drain fluids from your body or have other functions.

You’ll get medicine through an IV in your arm to help prevent blood clots. You’ll most likely need to take aspirin for the rest of your life, but you may only need to take another

antiplatelet

for six months.

 

Before long, you’ll be walking around your hospital room and hallways.

Your surgeon may recommend

cardiac rehab

to strengthen your heart during your triple bypass surgery recovery.

 

What are the advantages of triple bypass surgery?

Creating alternate routes for blood to reach your heart muscle protects that muscle from damage. This improves

chest pain

, shortness of breath and quality of life. You also may have a better chance of survival than people who receive other types of treatment. These include medicines or angioplasty and

stenting

.

 

Triple bypass surgery is a good option for people with multiple blockages. Their cases are too complex for angioplasty and stenting to be as effective as surgery.

What are the risks or complications of triple bypass heart surgery?

More than 95% of people who have a coronary bypass surgery don’t have serious complications. However, complication risks may be higher for people who have certain other health conditions or are having emergency surgery.

Complications may include:

• Kidney failure

  .

• Stroke

  .

• Blood clots

  .
• Failure of the relocated blood vessel.
• Infection in your breastbone.

• Atrial fibrillation

  .

Generally, there’s less than a 1% chance that an elective triple bypass surgery could be fatal.

How long does it take to recover from triple bypass open-heart surgery?

Most people stay in an intensive care unit overnight and then a regular room for another three to five days. You’ll need about six weeks or more for triple bypass surgery recovery time after leaving the hospital. Some people may recover in four weeks, while others need longer. Healthcare providers encourage an early return to activities of daily living while avoiding strenuous activity. After six weeks, you may gradually start doing strenuous activity and heavy lifting.

When can I eat or drive again?

You should be able to eat a day or two after surgery and will walk around a day or two days after your operation.

You shouldn’t drive for six weeks. If you have open-heart surgery, your

breastbone is split

and wired back together. It’ll take some time to heal. During this time, don’t lift things that weigh more than 10 pounds. (For reference, a gallon of milk weighs 8 pounds.)

 

What is the life expectancy after triple bypass surgery?

People can live many years after a triple bypass surgery. Ten years after having a coronary artery bypass, more than 75% of people are still alive.

Taking prescribed medicines and making lifestyle changes give you a better long-term prognosis. These changes include:

• Eating a healthy diet.
• Avoiding tobacco use.
• Exercising regularly.

When should I see my healthcare provider?

Contact your provider if you have signs of infection after going home from the hospital. These signs include:

• Bleeding from your wound.

• Fever

  .
• Pain in your wound that gets worse.

• Fast heart rate

  .

Be sure to go to all follow-up appointments with your provider after triple bypass surgery. This will help ensure that you’re healing properly and aren’t having any complications.

A note from Cleveland Clinic

Because triple bypass surgery is a major surgery, finding an experienced surgeon can make you feel more at ease. Surgeons have been doing this procedure for decades. This is a trusted treatment for coronary artery disease. Be sure to ask questions about anything that isn’t clear. Knowing what to expect can give you peace of mind when you’re facing surgery.