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) WATCH Triple Bypass Open 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) What to Expect: 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) Open Heart Surgery: What to Expect (English CC)

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.

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(Video) Coronary Artery Bypass Graft (CABG ) Off-Pump PreOp® Patient Education

FAQs

How long are you sedated after triple bypass 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 many days pain will be there 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 long do I have to sit in the back seat after heart surgery? ›

This additional time is to allow your sternum to start to heal before you get back behind the wheel. Even if you have heart bypass surgery without having had a heart attack, you still need to wait four weeks before getting back behind the wheel.

How long are you in recovery room after bypass surgery? ›

You might be in this unit for 1 to 3 days. A longer stay does not mean that your CABG surgery was not successful. It may mean, for example, that it is taking more time for your anesthesia to wear off or for fluid in your chest to drain. As you wake up, you may notice several sensations.

How do you wipe after open heart surgery? ›

After using the toilet, clean by reaching through your legs and wiping front to back. Do not reach behind your back. If this is hard to do, your OT may advise you to use a toilet aid.

Do they take the breathing tube out before you wake up? ›

Ventilator (breathing machine)

You will be on the breathing machine (ventilator) until you are awake enough to have the breathing tube removed. The breathing machine is attached to a tube in your mouth that goes down your windpipe to help you breathe.

How do you stop coughing after bypass 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 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.

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.

What do you need at home after open heart surgery? ›

Activity
  1. Wear casual or comfortable clothes each day to help you get back into a regular daily routine.
  2. Break up long tasks into shorter parts, and space them over the day.
  3. Stop your tasks before you get tired. If you do too much, you'll likely be tired the next day and need to rest.
28 Apr 2015

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 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 do you get out of bed after 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.

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.

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.

Can you raise your arms after open heart surgery? ›

For the first 6 weeks after your surgery, you must be careful about using your arms and upper body when you move. Do not reach backward.

How do toilets work with sternal precautions? ›

02 Activity and sternal precautions - YouTube

Can you wash dishes after open heart surgery? ›

– Stop if you feel dizzy, palpitations, excessive sweating, severe tiredness, chest pain or severe shortness of breath. – Once you're home, you may start doing light household chores such as laundry, cooking, dusting and washing dishes if you feel able to.

How do doctors wake you up from anesthesia? ›

Currently, there are no drugs to bring people out of anesthesia. When surgeons finish an operation, the anesthesiologist turns off the drugs that put the patient under and waits for them to wake up and regain the ability to breathe on their own.

What goes down your throat during surgery? ›

Breathing Tubes

It's common for an endotracheal tube to be put into your mouth and down your throat, a process called intubation. This tube, which is inserted into your trachea, or windpipe, is then attached to a ventilator to provide oxygen during surgery and potentially during the early stages of recovery.

What do they put in your mouth during surgery? ›

During the procedure

Once you're asleep, the anesthesiologist may insert a tube into your mouth and down your windpipe. The tube ensures that you get enough oxygen and protects your lungs from blood or other fluids, such as stomach fluids.

What are the odds of surviving triple bypass surgery? ›

They also vary based on the age and other factors. 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 serious is a 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.

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].

Are you put on a ventilator after open 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.

Do sternal wires stay in forever? ›

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.

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 chest pain last after open heart surgery? ›

Pain – After surgery, pain is to be expected given the fact that the chest bone is the slowest to heal. So be aware that you will experience pain when you breathe, cough, sneeze and laugh. Usually after six weeks, this pain subsides.

How long does a triple heart bypass take? ›

During the procedure

Coronary bypass surgery generally takes between three and six hours and requires general anesthesia. The number of bypasses you need depends on where in your heart and how severe your blockages are. For general anesthesia, a breathing tube is inserted through your mouth.

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.

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.

How long do you cough after open heart surgery? ›

Conclusions: Postoperative changes in respiratory muscle strength and spirometry can persist up to at least 8 weeks postoperatively. Many patients report a change in respiratory symptoms of cough, phlegm, dyspnea, or wheeze.

How do you get out of bed after 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.

What are the side effects of triple bypass surgery? ›

Common postoperative symptoms include chest incision symptoms (pain, discomfort), shortness of breath, loss of appetite,3 fatigue,3,4 and difficulty sleeping. Psychological symptoms such as depression/sadness and anxiety/uneasiness have also been identified post-CABS.

How soon after open heart surgery do you start cardiac rehab? ›

Three to six weeks after you're discharged from the hospital, your cardiologist will recommend beginning an outpatient cardiac rehabilitation program.

How can I help my husband after open heart surgery? ›

4 Ways to Help Loved Ones After Heart Surgery
  1. Consider a Professional Care Giver. It's okay to admit that you don't have all the answers in post-surgery recovery. ...
  2. Expect a Few Appointments. ...
  3. Spend Time Outside. ...
  4. Plan Healthy Meals.
4 Jun 2018

What do you say to someone who has open heart surgery? ›

They might like to hear these positive words before surgery:
  1. "How can I help?" This shows them that you care and want to be there for them. ...
  2. "What are you feeling right now?" ...
  3. "It'll be okay." ...
  4. "I'll be waiting for you after surgery!" ...
  5. "Can I give you a hug?" ...
  6. "I Love You"
25 Aug 2019

Videos

1. Triple Bypass Heart Surgery: Cynthia's Story
(Penn Medicine)
2. Coronary Artery Bypass Surgery
(Cleveland Clinic)
3. Coronary Artery Bypass Graft Part 5 of 5: Recovery and Recuperation
(Dignity Health Sequoia Hospital)
4. Life After Open-Heart Surgery
(MU Health)
5. What should you expect on the day of heart surgery?
(Swedish)
6. Open Heart Surgery: Going Home
(ProvidenceSpokane)

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