Recovery after heart bypass surgery (CABG): week by week

Bypass surgery uses healthy blood vessels, usually from the leg or chest, to go round blocked coronary arteries. NHS.UK says the operation usually takes 3 to 6 hours, is usually done as open heart surgery and may take up to four grafts. Recovery differs between open and keyhole approaches, and keyhole is usually quicker though not always suitable. The table collects NHS.UK and BHF ranges; your own team's advice overrides them. The operation is explained in the guide to CABG.

NHS.UK says you usually go to intensive care, where machines record your heart and lungs. At first you may need a breathing machine connected to a tube in your throat, removed once you are fully awake, with oxygen through a mask afterwards. Tubes in the chest drain fluid and come out after one or two days, and pain relief is given as the anaesthetic wears off.

Physiotherapists and nurses help you out of bed from the day after surgery. Expect pain or discomfort in the chest, back or shoulders, some loss of appetite for the first few days and wounds on the chest and on the leg or wherever vessels were taken. Breastbone wires are usually left in permanently and the skin stitches dissolve.

NHS.UK recommends arranging for someone to help look after you for the first few days at home, following the team's wound-care advice, taking painkillers if needed, and starting activity such as walking as soon as you feel well enough. You will usually feel tired for the first few weeks. Keep taking medicines for coronary heart disease and follow advice about any changes.

The BHF says wounds can feel sore, itchy or numb while healing, and that hot, red, increasingly painful or swollen wounds, or discharge that smells unpleasant, should be reported. Some clothing can press on a chest wound, so loose, front-fastening clothing may be more comfortable. NHS.UK says you should be able to get back to most normal activities after about six weeks.

NHS.UK says no heavy lifting for three months, and the BHF says to avoid anything strenuous such as carrying heavy bags or hoovering until the wound has healed, usually 8 to 12 weeks after open heart surgery. You may be offered cardiac rehabilitation, an exercise programme with support. Alcohol should stay within recommended limits and smoking should be avoided, NHS.UK says.

The BHF suggests asking your hospital team when exercise, sex and intimacy are appropriate, as it depends on your surgery and health. It also says that many people worry about scars and that support is available.

Driving: NHS.UK says not for at least four weeks, or three months if you have a bus, coach or lorry licence, and to tell the DVLA if you hold one. GOV.UK says to ask your doctor how surgery affects your driving and to tell the DVLA if you are still unable to drive three months after the operation. It also says doctors should remind patients that ignoring advice to stop driving may affect insurance.

Work: no retrieved source gives a fixed date. Because NHS.UK says most normal activities return after about six weeks and full recovery takes two to three months, many people agree a phased return with their surgeon or occupational health. NHS.UK also says memory problems are common and usually improve over a few months, and the BHF says it is normal to feel worried and to talk about it.

NHS.UK says to call your care team for worsening pain or redness around a wound, bleeding or pus, a high temperature or feeling hot, cold or shivery, or noticeable palpitations. If you cannot reach them, ask for an urgent GP appointment or call 111. Call 999 for sudden chest pain or pressure that does not go away, pain spreading to the arm, neck, jaw, stomach or back, chest pain with sweating, sickness or breathlessness, or any stroke sign such as a drooping face, and do not drive yourself.