Triple Bypass Surgery: What to Expect on the Day of Surgery (2022)

Triple bypass surgery is a form of coronary artery bypass graft (CABG) surgery. CABG is the most common type of heart surgery performed on the adult population. Triple bypass simply refers to the number of vessels being bypassed (three). Through the utilization of an open chest technique, surgeons transport three vessels to the heart and surrounding area to bypass the damaged vessels.

By understanding what happens before, during, and after triple bypass surgery, you can increase your chances of success.

Triple Bypass Surgery: What to Expect on the Day of Surgery (1)

Before the Surgery

The day of triple bypass surgery can be hectic and overwhelming. If the surgery is planned, you will have more time to prepare both mentally and physically for the procedure. If it is an emergency, preoperative tests are very time sensitive and multiple examinations may be happening at once.

On the day of the procedure, you will meet with the entire healthcare team including the cardiothoracic surgeon, cardiologist, anesthesiologist, perfusionist, operating room nurses, and other surgeons as needed. All operative consent forms will be signed at this time to ensure you are fully prepared and do not have any additional questions or concerns.

The registered nurse will take vital signs including:

  • Heart rate
  • Blood pressure
  • Temperature
  • Respirations
  • Pulse oximetry
  • Blood sugar
  • Pain level

Prior to going into the operating room for the procedure, patients will have preoperative tests done. This will include:

  • Echocardiogram
  • Electrocardiogram (EKG or ECG)
  • Blood work
  • Chest X-ray
  • Carotid ultrasound
  • Pregnancy test (if indicated)

You will also be given a surgical soap that must be used on the surgical sites to properly cleanse the area and prevent infection. After cleaning, you will be given a hospital gown and the nurse will shave the surgical area if needed. The surgeon will mark the surgical site after you are fully prepped.

Your medications will be reviewed by the nurse and surgical team. Be prepared to discuss all of your medications, vitamins, and supplements at this time including the dosages, the last time they were taken, and how often they are taken. Bringing a list of the information is helpful so nothing is missed.

Patients are instructed to empty their bladder prior to going into the operating room, and asked to remove all jewelry, glasses, contact lenses, and dentures if applicable.

Finally, the nurse will insert an intravenous catheter (IV) that will be used to provide hydration, medications, and anesthetics during the procedure.

During the Surgery

When it’s time for the surgery, you will be taken into the operating room on a stretcher and then placed onto the operating room table. You will then be prepared for general anesthesia, which will last for the duration of the surgery. Before the operation begins, the following will take place:

(Video) What to Expect: Heart Surgery

  • You will be given a small dose of medication to help you relax while the surgical team is preparing.
  • Vital sign monitors are placed.
  • Your skin will be cleaned again with surgical cleaner and draped in sterile drapes, exposing only the surgical area(s).
  • Once you are sedated by the anesthesiologist, an endotracheal tube will be placed to help you breathe during the procedure. Anesthesia medications relax your muscles making it difficult to breathe and this procedure will allow the team to help control your breathing while on the ventilator.

Once you are fully prepped for surgery, the surgical team will first harvest the three vessels needed for the bypass. Blood vessels can be taken from your leg (saphenous vein), inside your chest (internal mammary artery), or your arm (radial artery).

After the surgeons harvest the vessels, a midsternal vertical incision is made in the center of the chest in order to access the heart. The patient may be placed on a bypass machine during the procedure depending on the surgeon. The surgery can be performed "on-pump" or "off-pump".

On-pump surgery refers to the use of a heart-lung machine that circulates blood and breathes for the body throughout the surgery. The machine allows doctors to stop the heart.

The second technique used is off-pump surgery, also called “beating heart surgery.” It is done while the heart is still beating, and does not use the heart-lung machine. This is a more difficult surgery to perform because of its technical precision, but is the preferred approach for some surgeons.

According to the National Institute for Health and Care Excellence (NICE), the procedure works as well as a coronary artery bypass using a pump. It is a newer technique that has shown some increased benefits, including:

  • Quicker than the conventional procedure
  • Reduces the chance of bleeding during the surgery
  • Decreased risk of certain serious complications after surgery, such as a stroke
  • Shortened hospital stay

After the grafts have been placed, the heart is restarted (if needed) via controlled electrical shocks. The surgical incision is closed using mesh webbing, sutures, and/or staples depending on the surgeon's preference.

Steps of Open Heart Bypass Surgery

After the Surgery

Immediately following triple bypass surgery, you will be transferred to the intensive care unit (ICU) or cardiac intensive care unit (CICU or CCU) for close monitoring. You will typically have an endotracheal breathing tube for several hours after surgery and still be connected to a ventilator.

You will be given medication to keep you sleepy. If you start to wake up, you will not be able to talk with the breathing tube. It may feel uncomfortable but shouldn't be painful. Once fully awake, the breathing tube will be removed.

You will spend a minimum of one day in the intensive care unit and will be hooked up to a variety of machines including a monitor for vital signs, an IV pump to deliver fluids and medications, and a catheter to drain your bladder.

After the initial ICU recovery, you will be moved to a telemetry medical-surgical unit to continue your recovery. At this time, you will meet with a physical therapist, occupational therapist, and nutritionist to continue the recovery process.

Following the procedure, everything will be harder to do including eating, dressing, bathing, and other activities of daily living. This is normal and to be expected after undergoing triple bypass surgery. Working with the healthcare team will help you start to feel more normal.

(Video) WATCH Triple Bypass Open Heart Surgery

Triple Bypass Surgery: Recovery

A Word From Verywell

It's important to follow all instructions from the healthcare team before, after, and during triple bypass surgery. This surgery, while the most common open heart procedure, is very serious and there is the possibility of life-threatening complications.

Discuss any concerns and questions with your surgeon prior to the procedure to fully understand not only the surgical procedure but also the recovery process.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Melly L, Torregrossa G, Lee T, Jansens JL, Puskas JD. Fifty years of coronary artery bypass grafting.J Thorac Dis. 2018;10(3):1960-1967. doi:10.21037/jtd.2018.02.43

  2. Society for Cardiovascular Angiography and Interventions. Your care team during coronary bypass surgery.

  3. National Heart, Lung, and Blood Institute.Coronary artery bypass grafting.

  4. Johns Hopkins Medicine. Coronary artery bypass graft surgery.

  5. University of Michigan Health. Coronary artery bypass surgery: When you arrive at the hospital.

  6. Martínez-González B, Reyes-Hernández CG, Quiroga-Garza A, et al. Conduits used in coronary artery bypass grafting: A review of morphological studies.ATCS. 2017;23(2):55-65. doi:10.5761/atcs.ra.16-00178

  7. Johns Hopkins Medicine. Off-pump coronary artery bypass surgery.

  8. National Institute for Health and Care Excellence. Off-pump coronary artery bypass grafting: Interventional procedures guidance. Published January 26, 2011.

(Video) What should you expect on the day of heart surgery?

Triple Bypass Surgery: What to Expect on the Day of Surgery (2)

By Kathleen Gaines, MSN, RN, CBC
Kathleen Gaines, MSN, RN, CBC, is a nurse and health journalist, as well as an adjunct clinical faculty member at hospitals in the Philadelphia area.

FAQs

What happens the day after triple bypass surgery? ›

You will feel tired and sore for the first few weeks after surgery. You may have some brief, sharp pains on either side of your chest. Your chest, shoulders, and upper back may ache. These symptoms usually get better after 4 to 6 weeks.

What happens immediately after bypass surgery? ›

As you wake up, you may notice several sensations. You will probably feel very groggy. Anesthesia can make you feel nauseated, so your stomach may feel queasy. You may also notice immediately that you cannot swallow or speak because of the tube placed in your throat to help you breathe.

How many hours does triple bypass surgery take? ›

Triple bypass surgery is typically performed via an open heart procedure— your surgeon will cut your chest open with a vertical incision to access the heart. Surgery typically lasts between three to eight hours, depending on the extent of the disease. The surgery can be performed "on-pump" or "off-pump".

What can I expect immediately after open heart surgery? ›

You may feel very sleepy, thirsty, or cold, and sick to your stomach. It's also common to be confused and disoriented for a time after heart surgery. You will likely have a tube in your throat that is connected to a ventilator to help you breathe. You won't be able to talk while the tube is in place.

What is the most common complication after bypass surgery? ›

The major complications associated with CABG are death, myocardial infarction, stroke, wound infection, prolonged requirement for mechanical ventilation, acute kidney injury, and bleeding requiring transfusion or reoperation [1-4].

How long do you stay intubated after open heart surgery? ›

In most cases, all tubes are removed in 24 to 48 hours. Chest Tubes/Pacemaker Wires: Chest tubes allow blood and fluid that form inside your chest to drain out. The tubes are usually removed the first or second day after surgery.

How do you get out of bed after bypass surgery? ›

To get out of bed:
  1. Lie on your back and slowly scoot to the edge of the bed.
  2. Bend your knees slightly and roll slowly onto your side.
  3. Carefully push your body up, using the elbow beneath you and the arm on the other side of your body.
  4. At the same time, gently swing both legs to the floor.
  5. Sit for a moment.

How serious is triple bypass surgery? ›

Heart bypass surgeries are serious but relatively safe. Surgeons perform hundreds of thousands of heart bypass operations each year and many of those who have the surgery get relief from their symptoms without needing long-term medication. The more severe the heart disease, the higher the risk of complications.

How do you stop coughing after bypass surgery? ›

How to Cough After Surgery. When you feel the urge to cough, you should brace your incision if you have had a chest or abdominal surgery. That means taking your hands or a small pillow and hugging it to your incision when you cough, applying gentle but firm pressure.

How do you feel after bypass surgery? ›

It's natural to feel a bit low after having bypass surgery. You'll experience good and bad days.
...
These can include:
  • loss of appetite.
  • constipation.
  • swelling or pins and needles where the blood vessel graft was removed.
  • muscle pain or back pain.
  • tiredness and difficulty sleeping.
  • feeling upset and having mood swings.

How long is the heart stopped during bypass surgery? ›

Your heart will usually be stopped for about 30-90 minutes of the 3-6 hour surgery. The heart-lung machine makes it possible for the surgeon to work on a still heart. This technique has been used for many years with excellent results. Once the surgery is over, the surgeon and perfusionist restart your heart.

What is the fastest way to recover from bypass surgery? ›

Even though you may feel drained physically and emotionally, it's important to follow guidelines for good self-care:
  1. Get dressed every day.
  2. Walk daily within your limits.
  3. Get plenty of rest.
  4. Resume hobbies and social activities you enjoy.
  5. Visit with others.
  6. Join a support group.
15 May 2019

When do they take breathing tube out after surgery? ›

Most people are on the ventilator while the surgery is taking place, then a drug is given after the operation is complete to stop the effects of the anesthesia. Once the anesthesia stops, the person is able to breathe on their own and is removed from the ventilator.

What is the most common complication after open heart surgery? ›

Bleeding. The most common complication after open heart surgery is bleeding from the area of the incision or surgery site. During the surgery itself as well as recovery, you will be closely monitored and your progress tracked.

Is it normal to sleep a lot after heart surgery? ›

Although each patient heals at different rates, it seems like many of us are lethargic, fatigued and tired after heart surgery. Personally, I remember feeling exhausted for the first ten weeks after my valve replacement surgery.

How long are you in hospital after a triple heart bypass? ›

The average stay in hospital after heart bypass is six nights and usually consists of about one night in intensive care, one night in the high dependency unit and about four nights on the ward.

How long do sternal wires last? ›

When that sternum is together, like any broken bone, it will mend to about 90 percent of its normal tensile strength about 8 to 10 weeks after the bone has been put together again. At that point, the bone is essentially mended, and you don't need the wires anymore.

Can you go home alone after open heart surgery? ›

You should have someone stay with you in your home for at least the first 1 to 2 weeks after surgery. Learn how to check your pulse, and check it every day. Do the breathing exercises you learned in the hospital for 4 to 6 weeks. Shower every day, washing the incision gently with soap and water.

Is it common to be on a ventilator after bypass surgery? ›

Patients undergoing cardiac surgery are generally able to resume spontaneous ventilation as soon as they have recovered from the anesthesia. However, approximately 2.6% to 22.7% of them require prolonged mechanical ventilation (MV), depending on the threshold selected to define prolonged MV.

Do they put you on a ventilator after heart surgery? ›

It is standard medical practice in the U.S. for cardiac surgery patients to be sedated and have a breathing tube in place the first night following heart surgery. However, longer duration of ventilation and time in intensive care units increases the risk of pneumonia and other hospital-acquired infections.

What happens when the breathing tube is removed? ›

A considerable number of patients admitted to the intensive care unit (ICU) die following withdrawal of mechanical ventilation. After discontinuation of ventilation without proper preparation, excessive respiratory secretion is common, resulting in a 'death rattle'.

How long should you stay in bed after surgery? ›

Get Plenty of Rest. With any major surgery, it's important to stay in bed as much as possible for at least 24–48 hours after the procedure. Some surgeries may require even more patient bed rest.

How long does chest hurt after bypass surgery? ›

You will feel tired and sore for the first few weeks after surgery. You may have some brief, sharp pains on either side of your chest. Your chest, shoulders, and upper back may ache. These symptoms usually get better after 4 to 6 weeks.

How do you go to the bathroom after open heart surgery? ›

Bathroom tasks

Do not take a tub bath until your incisions (cuts) are healed. This will take at least 4 to 6 weeks after surgery. Use a hand-held shower head can help you reach places on your body more easily. Use grab bars in your tub or shower if you have trouble moving around.

What is the survival rate of a triple bypass? ›

Survival rates

For example, the mortality rate after bypass surgery according to the national Medicare Experience shows that the 30-day survival rate was more than 95 percent for people ages 65 to 69 and about 89.4 percent for people 80 years and older.

How fast can arteries clog after bypass surgery? ›

Within a year after surgery, the vein segments can become blocked - about 15% of the time, which can lead to the recurrence of chest pain. “Improving the rate at which vein grafts remain open has always been a core issue of CABG surgery,” said cardiac surgeon Shengshou Hu, M.D., Ph.

What medications do you take after bypass surgery? ›

Medications
  • to reduce cholesterol,
  • antiplatelets and aspirin to prevent blood clots,
  • beta-blockers and ACE inhibitors to help lower blood pressure, and.
  • nitrates to control chest pain (if some diseased blood vessels could not be bypassed).
21 Jul 2016

How do you sneeze after bypass surgery? ›

Instead, use a surgical support vest to keep your wound and chest area sturdy, comfortable, and protected during all daily activities--including coughing and sneezing.

What happens if you cough during surgery? ›

How Illness Can Affect Anesthesia. Sometimes even minor illness, such as a cough, runny nose or fever, can cause problems during surgery and anesthesia. If this is the case, your anesthesiologist may decide to postpone surgery.

Will coughing open my incision? ›

Cough and Sneeze Carefully

A new incision isn't very strong and a violent sneeze can actually cause a surgical incision to open. Bracing your incision, which means applying pressure to the incision, is essential when coughing, sneezing or even going to the bathroom.

When can I drive after bypass surgery? ›

Your surgeon needs to make sure your sternum has healed before it's safe to start driving again. Once it has healed, you should be able to resume driving, typically within four to six weeks following surgery.

How long do you stay in the hospital after bypass surgery? ›

How long does heart bypass surgery recovery usually take? After CABG, most people stay in the hospital for 5 to 7 days. While you're there, you can expect the following: You will probably be on a ventilator, or breathing machine.

How painful is open heart surgery? ›

Generally, open heart surgery is not a painful experience. One notable exception is the removal of the drainage tubes, which typically occurs on post-operative day one. It may feel a bit odd and sometimes can be a brief source of pain. It will feel uncomfortable when you cough, laugh or sneeze.

How big is the incision for bypass surgery? ›

A series of small incisions is made between your ribs on the left side of your chest, directly over the artery to be bypassed. The incisions usually are about 3 inches long. (The incision made in traditional CABG is at least 6 to 8 inches long.)

Why is the body cooled for heart surgery? ›

Cooling Techniques

By cooling the heart, its need for oxygen is reduced. This allows surgeons to work on the heart for two to four hours without damaging the heart tissue.

How long does it take to wake up after open heart surgery? ›

You may not wake up from the anesthesia for two to four hours. During this time, you will continue to breathe through the breathing tube with help from a ventilator, a machine that will move air in and out of your lungs, essentially “breathing” for you.

How long does fatigue last after bypass surgery? ›

Patients who undergo surgery, including cardiac surgery, tend to experience fatigue that peaks between 2- to 4-weeks postoperatively. Cytokine levels and opioid use can contribute to the sleep disturbances linked to this early postoperative fatigue.

What is the most common complication after open heart surgery? ›

Bleeding. The most common complication after open heart surgery is bleeding from the area of the incision or surgery site. During the surgery itself as well as recovery, you will be closely monitored and your progress tracked.

How long does it take to wake up after bypass surgery? ›

It may be as short as 3 to 4 days. If you have complications, you may stay in the hospital several weeks or longer. Read on to learn more about what to expect during your recovery in the hospital after open-heart surgery. After open-heart surgery, you will wake up in the intensive care unit (ICU).

How do you take care of a patient after bypass surgery? ›

You should have someone stay with you in your home for at least the first 1 to 2 weeks after surgery. Learn how to check your pulse, and check it every day. Do the breathing exercises you learned in the hospital for 4 to 6 weeks. Shower every day, washing the incision gently with soap and water.

What is the fastest way to recover from bypass surgery? ›

Even though you may feel drained physically and emotionally, it's important to follow guidelines for good self-care:
  1. Get dressed every day.
  2. Walk daily within your limits.
  3. Get plenty of rest.
  4. Resume hobbies and social activities you enjoy.
  5. Visit with others.
  6. Join a support group.
15 May 2019

How serious is triple bypass surgery? ›

Heart bypass surgeries are serious but relatively safe. Surgeons perform hundreds of thousands of heart bypass operations each year and many of those who have the surgery get relief from their symptoms without needing long-term medication. The more severe the heart disease, the higher the risk of complications.

How long do sternal wires last? ›

When that sternum is together, like any broken bone, it will mend to about 90 percent of its normal tensile strength about 8 to 10 weeks after the bone has been put together again. At that point, the bone is essentially mended, and you don't need the wires anymore.

How long are you in hospital after a triple heart bypass? ›

The average stay in hospital after heart bypass is six nights and usually consists of about one night in intensive care, one night in the high dependency unit and about four nights on the ward.

How do you get out of bed after heart bypass surgery? ›

Getting out of bed
  1. Lie on your back and slowly scoot to the edge of the bed.
  2. Bend your knees slightly and roll slowly onto your side.
  3. Carefully push your body up, using the elbow beneath you and the arm on the other side of your body.
  4. At the same time, gently swing both legs to the floor.
  5. Sit for a moment.

Do you always go to ICU after heart surgery? ›

Open heart surgery is a major operation that requires close monitoring and immediate post-operative support. It is normal for a person to remain in the intensive care unit (ICU) for a couple of days after the procedure to receive further care.

Do they put you in a coma after heart surgery? ›

True prolonged postoperative coma is relatively uncommon, with estimates ranging from 0.005 to 0.08 percent following general surgery, but with higher rates reported after cardiac surgery.

How do you stop coughing after bypass surgery? ›

How to Cough After Surgery. When you feel the urge to cough, you should brace your incision if you have had a chest or abdominal surgery. That means taking your hands or a small pillow and hugging it to your incision when you cough, applying gentle but firm pressure.

Is it normal to sleep a lot after heart surgery? ›

Although each patient heals at different rates, it seems like many of us are lethargic, fatigued and tired after heart surgery. Personally, I remember feeling exhausted for the first ten weeks after my valve replacement surgery.

How long does chest pain last after bypass surgery? ›

You may have some brief, sharp pains on either side of your chest. Your chest, shoulders, and upper back may ache. These symptoms usually get better after 4 to 6 weeks. The incision in your chest and the area where the healthy blood vessel was taken may be sore or swollen.

When can I drive after bypass surgery? ›

Your surgeon needs to make sure your sternum has healed before it's safe to start driving again. Once it has healed, you should be able to resume driving, typically within four to six weeks following surgery.

Can you go home alone after open heart surgery? ›

During the first week or two, you should have a caregiver help you with your initial aftercare. This can be a family member, friend or home health aide. Heart surgery aftercare at home will include: Caring for your incision and monitoring for signs of infection.

What is the survival rate of a triple bypass? ›

Survival rates

For example, the mortality rate after bypass surgery according to the national Medicare Experience shows that the 30-day survival rate was more than 95 percent for people ages 65 to 69 and about 89.4 percent for people 80 years and older.

Videos

1. Life After Open-Heart Surgery
(MU Health)
2. How Does Heart Bypass Surgery Work? Coronary Artery Bypass Graft Procedure Animation - CABG Video
(AniMed)
3. Coronary Artery Bypass Surgery
(Cleveland Clinic)
4. Coronary Artery Bypass Graft Part 5 of 5: Recovery and Recuperation
(Dignity Health Sequoia Hospital)
5. Stories of the Heart: Coronary Artery Bypass
(Carilion Clinic)
6. Open Heart Surgery: A Patient's Experience
(ProvidenceSpokane)

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