Heart disease continues to be one of the leading health concerns worldwide, and one of the most commonly performed life-saving procedures is bypass surgery-medically known as Coronary Artery Bypass Grafting (CABG).
Yet, many people still confuse bypass surgery with open-heart surgery. Though both involve operating near the heart, they are not the same.

This blog simplifies what bypass surgery is, why it’s done, and how it differs from an open-heart operation.

What Is Bypass Surgery?

Bypass surgery (CABG) is a surgical procedure used to treat blockages in the coronary arteries-the blood vessels that supply oxygen-rich blood to the heart.

Over time, cholesterol deposits (plaques) can narrow or block these arteries. When this happens, the heart struggles to get enough oxygen, leading to symptoms such as:

• Chest pain
• Shortness of breath
• Fatigue
• Risk of heart attack

During bypass surgery, doctors create a new route for blood to reach the heart.
A healthy blood vessel is taken from the patient’s leg, chest, or arm and attached above and below the blocked area, forming a bypass.
This allows the blood to flow smoothly again, improving heart function and reducing symptoms.

Why Is Bypass Surgery Needed?

Doctors recommend bypass surgery for:

• Multiple or severe coronary blockages
• Failed angioplasty or stent placement
• When angioplasty is not suitable
• Persistent chest pain (angina)
• Reducing the risk of future heart attacks
• Improving long-term heart health and quality of life

Most patients stay in the hospital for 5–7 days, and full recovery usually takes 6–12 weeks, depending on their overall health and lifestyle.

Bypass Surgery vs. Open-Heart Surgery: What’s the Difference?

One of the most common misconceptions is that bypass surgery = open-heart surgery.
While both procedures involve opening the chest, the purpose and technique are different.

1. The Purpose

• Bypass Surgery: Performed when heart blood vessels are blocked.
  The heart itself is not opened during the procedure.
• Open-Heart Surgery: Performed when there is a structural problem inside the heart, such as:
  • Holes in the heart (ASD/VSD)
  • Damaged heart valves
  • Tumors inside the heart chambers

2. Use of Heart-Lung Machine

• Bypass Surgery:
  Many CABG procedures today are done without stopping the heart and often without using a heart-lung machine.
  This is called off-pump bypass surgery.
• Open-Heart Surgery:
  The heart is stopped, and a heart-lung machine takes over the work of the heart and lungs during the procedure.

3. Chest Opening

In both types of surgeries, the breastbone (sternum) is typically opened to access the heart area-but what happens inside is very different.

Dr. Ashwin Kumar
MBBS | MS (Gen Surgery) | MCh (Cardio-Thoracic Surgery)
Consultant – Cardiothoracic Surgeon