Heart Bypass Surgery (CABG) in India: The Patient Journey

Coronary artery bypass graft surgery (CABG), often called heart bypass surgery, improves blood flow to the heart by using a healthy blood vessel from elsewhere in the body to get round a narrowed or blocked artery. The NHS says the operation usually takes three to six hours, most people spend about a week in hospital, and full recovery usually takes two to three months. Medwell's package estimate for CABG is USD 4,800 to 7,100, confirmed only after the hospital has reviewed your reports.

Below, we walk through the whole journey so you and your family know what to expect.

Why is heart bypass surgery done?

CABG treats coronary heart disease, where the arteries that supply blood to the heart become narrowed or blocked. According to the NHS, it may be recommended when:

• medicines are not enough to control symptoms such as chest pain (angina);
• doctors think you are at high risk of a heart attack;
• a simpler procedure, coronary angioplasty and stent insertion, is not suitable for you.

The NHS notes that bypass surgery does not cure heart disease, but it helps with symptoms such as chest pain and shortness of breath, and reduces the risk of a heart attack.

Whether you need bypass surgery, a stent or a different treatment is a decision for your cardiologist and cardiac surgeon. Before recommending treatment, doctors usually look at an angiogram, a type of X-ray of the heart's blood vessels. If you have had one at home, include it with your reports. If not, the hospital may recommend coronary angiography first.

Medwell package estimate

Medwell's package estimate for CABG is USD 4,800 to 7,100. This is a package estimate: it is confirmed only after the hospital's cardiac team has reviewed your reports and agreed a plan. Send us your reports for a free, no-obligation personalised quote within 24 hours.

What happens during the operation

The NHS describes the main steps as follows:

1. You are given a general anaesthetic, so you are asleep throughout.
2. The surgeon usually makes a cut down the centre of the chest and through the breastbone (open heart surgery). Sometimes several smaller cuts and a camera are used instead (keyhole surgery), which usually means a quicker recovery but is not always suitable.
3. One or more healthy blood vessels are taken, usually from the leg or chest.
4. The heart is usually connected to a heart-lung bypass machine to keep blood flowing around the body.
5. The healthy vessels are attached (grafted) so blood can flow around the damaged part of the artery. Up to four grafts may be needed.
6. After open heart surgery, the breastbone is closed with metal wires, which are usually left in permanently.

The NHS explains that most people need treatment for three arteries (a triple bypass) or four (a quadruple bypass), while some need one or two.

In hospital after surgery

According to the NHS, you will usually go to intensive care straight after the operation. At first a ventilator may help you breathe, and tubes may drain fluid from your chest for one or two days. You will usually move to a ward after one or two days, and nurses and physiotherapists help you out of bed and moving from the day after the operation. Most people spend about a week in hospital.

Recovery milestones

The NHS gives this general picture of recovery:

• You will usually feel tired for the first few weeks, and may have pain in your chest, back or shoulders.
• Most people can return to most normal activities after about six weeks.
• Full recovery usually takes two to three months.
• No heavy lifting for three months.
• No driving for at least four weeks.
• Follow-up appointments check your progress, and you may be offered cardiac rehabilitation: an exercise programme with support to help you recover.

Possible complications

The NHS lists possible complications including wound infection, bleeding, heart rhythm problems, kidney problems, memory problems, and heart attack or stroke during or soon after the operation. It notes that doctors only recommend bypass surgery if its risks are lower than the risks of not treating the heart problem. Your surgeon will explain what applies to you.

Planning your stay and flight home

Your cardiac surgeon decides when you are fit to fly. Cleveland Clinic advises anyone recovering from heart surgery to check with their doctor before flying, and explains that long periods of sitting still, lower oxygen levels and dry cabin air can all place extra strain on the body. Its practical tips include:

• carrying your heart-related medical information, including your doctors' contact details and a copy of your ECG;
• keeping enough medicine for the whole trip, plus a few extra days, in your hand luggage in its original container;
• drinking water rather than alcohol on the flight;
• asking your doctor whether compression stockings are right for you.

We recommend keeping your return date flexible. Medwell can arrange a hotel near your hospital for the days between discharge and your flight, and help rebook flights if your surgeon advises a longer stay.

Where to have heart surgery in Delhi NCR

Our partner hospitals include Fortis Escorts Heart Institute in New Delhi, as well as multi-speciality centres such as Fortis Memorial Research Institute and Artemis Hospital in Gurugram. Browse cardiac surgeons on our doctors page, and we will book a consultation with the specialist you choose. An interpreter is available on request.

Sources

• NHS: What is a coronary artery bypass graft?
• NHS: Why a coronary artery bypass graft is done
• NHS: How a coronary artery bypass graft is done
• NHS: Recovering from a coronary artery bypass graft
• NHS: Complications of a coronary artery bypass graft
• Cleveland Clinic: What to know if you're flying with heart problems
• Government of India: e-Visa information (indianvisaonline.gov.in)