Heart Bypass Surgery (CABG)

On-pump CABG uses a heart-lung machine to temporarily stop the heart, allowing the surgeon to work on a still surface, while off-pump (beating-heart) CABG is performed with the heart still beating using mechanical stabilizers. Off-pump surgery may reduce short-term stroke risk, but large trials show it can lead to fewer completed grafts and lower graft patency rates, with on-pump CABG generally demonstrating superior long-term survival outcomes.

Arterial grafts (such as the internal mammary artery) can remain open for 20 years or more, while saphenous vein grafts have a 50-60% patency rate at 10 years. The most important factor for graft longevity is maintaining LDL cholesterol below 70 mg/dL with high-intensity statin therapy, along with not smoking and controlling blood pressure and diabetes.

Request your angiogram, echocardiogram, and any CT angiography on CD in DICOM format — the universal medical imaging standard. Most international cardiac centers accept records via their secure patient portal or encrypted email. Send records at least 2-3 weeks before travel so the surgical team can review your case and confirm you are a suitable candidate before you fly.

Comprehensive cardiac surgery packages typically include all pre-operative testing (blood work, imaging, anesthesia assessment), the surgical procedure, ICU stay, a 7-10 day hospital stay, in-hospital cardiac rehabilitation, medications during your stay, and follow-up consultations before discharge. Items usually excluded are international flights, hotel accommodation during recovery, travel insurance, and long-term cardiac rehabilitation at home.

Before traveling, discuss your plans with your home cardiologist and ask if they will manage post-surgical follow-up. Request a detailed operative report from the overseas hospital including graft details, intra-operative findings, and recommended follow-up schedule. Most international cardiac centers provide English-language discharge documentation designed for continuity of care with overseas physicians.