Surgery: What to Expect – Beating Heart Bypass

Beating heart coronary artery bypass surgery helps to improve the lives of tens of thousands of people every year.

During beating heart bypass surgery, your heart continues to beat. You will not be put on a heart-lung machine. The part of your heart the surgeon works on is held still by a tissue stabilizer.

Before the Procedure

Today’s beating heart surgery patients can take care of most of the preparation for surgery on an outpatient basis.

You will need to get chest x-rays, blood work, an electrocardiogram (ECG), and a coronary angiogram. An ECG detects and locates the source of the heart problem. An angiogram is a type of x-ray that uses dye to make the arteries that feed your heart visible. These tests give your surgeon a good idea of your overall health and where the blockages are located.

You will also meet with your doctor, nurses and other members of your healthcare team. They will provide information and education about your upcoming surgery. This is a great time to ask questions and discuss any concerns you have.

During the Procedure

Off-pump heart bypass surgery usually lasts from 3 to 6 hours1 – depending on how many arteries are involved. You will get a general anaesthetic and a breathing tube. Your heart will continue to beat during surgery.

First, your surgeon makes an incision down your chest. Your breastbone is divided to allow access to your heart. Next, the surgeon harvests veins or arteries from somewhere else in your body to create grafts. For MICS (minimally invasive) CABG procedures, a small incision is made between your ribs.

The surgeon attaches one end of the graft above the blockage and the other end below the blockage. To attach the grafts while the heart is beating, the surgeon uses a stabilization device to keep a small section of the heart still. Typically, a heart positioner is also used. Once the grafts are sewn into place, the chest incision is closed.

After the Procedure

While procedures may vary from hospital to hospital, after your surgery, you will be monitored closely in the intensive care unit (ICU). Once you have been stabilised and are alert, you will be transferred to a step-down unit where you will stay until discharged. Beating heart CABG and MICS CABG patients commonly have shorter ICU stays than conventional CABG patients.2,3

Your cardiac surgeon, cardiologist, physiotherapist and coronary care nurses will work with you and your family to answer any questions that you have. They will instruct you on topics such as incision care, diet, medications, activity, and other questions that might arise.

Your healthcare team will determine when you are ready to go home. Both beating heart CABG and MICS CABG approaches can potentially lead to shorter hospital stays compared to conventional bypass.2 Once you are discharged, they will give you instructions on what to expect as you continue your recovery at home.


  1. Heart Center, The North American Heart Risk Study. Available at:
  2. Puskas J Cheng D, Knight J, Angelini G, DeCannier A, Dullum M, Martin J, Ochi M, Patel N, Sim E, Trehan N, Zamvar V. Off-pump versus conventional coronary artery bypass grafting; a meta-analysis and consensus statement from the 2005 ISMICS Consensus Conference. Innovations. 2005; 1;3-27.
  3. Subramanian VA, Patel NU, Patel NC, Loulmet DF. Robotic assisted multivessel MidCAB with port-access stabilization and cardiac positioning: paving way for outpatient in CABG? Abstract submitted at the Society of Thoracic Surgeons meeting. San Antonio, TX January 25-28, 2004.


Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

Last updated: 22 Sep 2010

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