The bypass part of the surgery

When using a vessel from the forearm or leg a surgeon connects, or grafts, one end of the harvested vessel to the aorta- which allows blood to flow into the graft. The other end is attached to the coronary artery that has a blockage, bypassing the blocked portion of coronary artery to restore blood flow to the heart muscle.
It is not uncommon for a surgeon to perform one or more of these grafts during an operation — Depending upon how many bypass grafts the surgeon performs, this can be referred to as double (2), triple (3), quadruple (4) or more bypasses.

     Heart with bypass


During the bypass procedure, your surgeon has two options:

  1. Stop the heart and use a heart-lung machine (On-pump)
  2. Keep your heart beating during the operation (Off-pump)

On-pump bypass

Bypass procedures became routine in the 1960s, following the invention of the heart-lung machine. The heart-lung machine is a device that temporarily does the job of the heart and lungs. This allow the heart to be stopped during CABG surgery. The heart-lung machine supplies oxygen to the blood and keeps blood circulating while a surgeon is sewing the grafts.

Once the operation is complete, the heart is returned to its normal rhythm and the heart-lung machine is no longer needed.

The heart-lung machine made it possible for surgeons to save the lives of millions of patients and On-pump bypass surgery remains the standard of care. This routine procedure carries the risk of infection, hemorrhage, stroke, heart attack and death.

Off-pump bypass

With off-pump bypass, the heart continues to beat and supply oxygenated blood throughout the body while the surgeon performs the bypass grafts. Certain patient populations may benefit from off-pump bypass surgery. They include patients with diabetes, kidney diseases, and those with a significantly poor functionning heart.
With any cardiac surgical procedure infection, hemorrhage, stroke, heart attack and death are potential risks. Talk with your surgeon to discuss which option is best for you.