What is CABG?
Coronary artery bypass grafting — commonly called bypass surgery, heart bypass, or open heart surgery — restores blood flow to the heart when the coronary arteries become narrowed or blocked by coronary artery disease. A healthy blood vessel, taken from your own chest, arm, or leg, is used to create a new route that carries blood past the blockage to the heart muscle beyond it.
The goal is to relieve angina, reduce the risk of a heart attack, and improve both quality and length of life in people with significant coronary disease.
Who needs bypass surgery?
A surgical bypass is generally considered when blockages are too advanced or too numerous to treat well with stents alone. Dr. Zain Subhani assesses each case against current ACC/AHA and ESC guidelines, considering:
- Significant disease in two or three coronary arteries (multi-vessel disease)
- Disease of the left main coronary artery
- Diabetes alongside multi-vessel disease, where bypass often outperforms stenting
- Reduced heart pumping function (low ejection fraction)
- Symptoms that persist despite medication or after angioplasty
On-pump and off-pump (beating heart) bypass
There are two established ways to perform CABG, and Dr. Zain Subhani is experienced in both:
On-pump CABG
The heart is temporarily stopped and a heart-lung machine takes over circulation while the grafts are sewn in a still, bloodless field. This remains the standard approach for many patients and offers excellent precision.
Off-pump CABG — beating heart surgery
The bypass is performed while the heart continues to beat, without the heart-lung machine, using stabilising instruments. In carefully selected patients — particularly those with kidney disease or a higher stroke risk — this can reduce certain complications. Read more about beating heart surgery.
What happens during and after surgery
A bypass operation usually takes three to five hours depending on the number of grafts. Afterwards you spend one to two days in the cardiac ICU, then three to five days on the ward as you begin moving and breathing exercises — a total stay of about five to seven days.
Recovery and rehabilitation
Full recovery after bypass surgery usually takes six to eight weeks. Most patients walk short distances within days, gradually increase activity, and return to light work around six weeks, guided by their surgeon.
Risks of CABG
Bypass is one of the most studied and established operations in all of surgery, and for most patients the benefit clearly outweighs the risk. Possible complications include bleeding, infection, irregular heart rhythm, and — less commonly — stroke or kidney strain. Individual risk depends on age, heart function, kidney function, and conditions such as diabetes. At a high-volume tertiary centre like Punjab Institute of Cardiology, outcomes are comparable to international benchmarks.
Cost of bypass surgery in Lahore
The cost of CABG varies with the hospital, room category, surgical technique, and any additional procedures or ICU requirements. Public-sector tertiary centres such as PIC offer substantially subsidised treatment, while private hospitals offer package-based pricing. An accurate estimate is only possible after surgical assessment — message on WhatsApp to discuss your specific situation.
Frequently asked questions
Who needs CABG (bypass surgery)?
CABG is recommended for significant multi-vessel coronary artery disease, left main disease, or when symptoms persist despite medication or after angioplasty. The decision is based on your coronary anatomy, heart function, diabetes, and kidney function, guided by ACC/AHA and ESC recommendations.
How long does CABG surgery take?
Most bypass operations take three to five hours depending on the number of grafts and complexity, followed by one to two days of recovery in the cardiac ICU.
Is bypass surgery safe?
CABG is one of the most studied operations in surgery. Major risks include bleeding, infection, and stroke, and overall risk depends on age, heart function, kidney function, and comorbidities. At high-volume centres such as PIC, outcomes are comparable to international benchmarks.
How long is recovery after bypass surgery?
Hospital stay is usually 5-7 days. Full recovery takes 6-8 weeks, with a gradual return to walking, daily activity, and eventually work, supported by structured follow-up and cardiac rehabilitation.