Coronary artery bypass surgery (CABG) is a major heart operation that is carried out on almost 30,000 people each year in the UK alone. This is a planned operation but may be needed promptly because of the imminent risk of a heart attack, or because the pain of angina is becoming difficult to cope with. Although often carried out within the National Health Service (NHS), private heart bypass surgery is becoming more readily available, particularly in the larger private hospitals in major cities.
Who needs heart bypass surgery?
Cardiovascular disease is one of the most common chronic diseases of middle age. It is partly due to the effects of ageing on the blood vessels and heart and partly due to genetics and environmental factors. People who eat a lot of fatty and sugary food (takeaways, chips, burgers and chocolate, for example) and do very little exercise tend to develop atherosclerosis, whether or not they gain weight and look unhealthy from the outside.
Atherosclerosis causes fatty plaques to build up inside the walls of the arteries, which then harden and also narrow. Blood is less able to pass through the arteries as freely as it once did, and the tissues supplied by the affected blood vessels can get short of oxygen. When this happens in the coronary arteries, the blood vessels that feed the heart muscle, it causes the pain of angina. If the vessel becomes blocked by a blood clot, this stops the blood supply altogether, causing a heart attack.
Heart bypass surgery is done to relieve the pain of angina and to reduce the risk of a heart attack. It is therefore recommended for anyone who has severe angina, and anyone whose coronary arteries have narrowings, as shown by an imaging test called an angiogram.
What happens during the surgery?
The aim of heart bypass surgery is to replace the diseased coronary arteries with pieces of healthy artery that are taken from elsewhere in the body, usually the legs. Bypass surgery is now almost routine but it is a major procedure as the heart has to be stopped to allow the cardiac surgeon to attach the new blood vessels. This means that a heart and lung machine, operated by a specialist perfusionist, must be used to make sure the blood supply to the rest of the body is kept as normal as possible.
An incision is made in the chest, along the length of the breastbone, and the rib cage is opened to allow access to the heart. The blood vessels are attached in several places and the number of vessels used is indicated in the name given to the operation. In a quadruple heart bypass, for example, four separate vessels are used to boost the blood supply to the heart muscle, taking over the job of the coronary arteries.
Options for private surgery in the UK
Since heart bypass surgery is a major operation that requires at least a short stay in an intensive care unit, it can only be done with private hospitals that have both an intensive care facility and the cardiology expertise and operating theatres necessary. Most of the smaller private hospitals around the UK can offer cardiac assessment but if you want to go privately for your heart operation, you will need to look at the larger private hospitals, or at private wings of NHS hospitals that specialise in cardiology.
Four of the largest centres for private heart bypass surgery are:
Private heart bypass surgery at Papworth Hospital, Cambridgeshire: the Papworth Clinic is the private patient’s centre at this major heart hospital and it offers CABG and other heart procedures to patients who are self-pay, insured through private medical insurance, or who are sponsored by their employer or by a foreign embassy (all international patients must have a private heart bypass as they are not eligible for NHS treatment).
Private cardiac bypass surgery at London Bridge Hospital, London: this large private hospital in central London has an established cardiothoracic unit with 26 private rooms dedicated to cardiac interventions and heart surgery, including bypass surgery. Its eight cardiac surgeons are supported by a team of ten consultant anaesthetists with considerable experience of heart surgery, and by intensive care facilities.
Private care for heart surgery at Cromwell Hospital, London: this private hospital, run by BUPA, has advanced diagnostic facilities, including an angiography suite that is equipped with 3D imaging. The expert surgeons offer heart bypass surgery with an open operation and heart and lung machine support, and a minimally invasive heart bypass surgery technique, which does not require the heart to be stopped.
Specialist cardiac care at the private Spire Hospital in Southampton: over 600 heart operations are carried out each year by a team of cardiothoracic surgeons. Private heart bypass surgery is available, as is heart valve repair, and replacement of heart valves with mechanical prostheses.