Concierge cardiothoracic surgery · London
Coronary artery bypass (CABG), by a consultant cardiothoracic surgeon.
When your angiogram shows left‑main or triple‑vessel disease, the conversation shifts from stents to bypass — and the person holding the scalpel matters more than almost anything else. In London you can be assessed by a high‑volume consultant cardiothoracic surgeon within a week, discussed at a heart‑team MDT, and operated on inside two to three weeks, with LIMA to LAD as the durable core and everything else chosen to fit your anatomy rather than surgeon habit.
Why patients choose us
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A consultant cardiothoracic surgeon, in theatre
Not a trainee list and not a rushed slot. A named consultant surgeon, a proper cardiac theatre, and an MDT decision behind every operation.
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Multi-conduit and off-pump capability
LIMA to LAD as the gold standard, additional arterial grafts where they earn their place, and off-pump, MIDCAB or robotic (TECAB) options where the anatomy fits.
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Independent, and free
We are paid by no clinic, so the recommendation — CABG, PCI or hybrid — is impartial and costs you nothing.
Indicative pricing
What a private CABG costs in London.
Indicative all-in ranges — surgeon, anaesthetist, theatre, ICU and hospital stay. Send the details and we quote firm figures across two or three surgeons.
In short
A standard on-pump CABG in our network: £28,000–£45,000 all-in, hospital stay 5–7 days.
| Procedure | Indicative range | Typical duration | Hospital stay |
|---|---|---|---|
| On-pump CABG (standard) | £28,000–£45,000 | 3–5 hrs | 5–7 day stay |
| Off-pump CABG (OPCAB) | £30,000–£48,000 | 3–5 hrs | 5–7 day stay |
| MIDCAB (mini-thoracotomy, LIMA-LAD) | £30,000–£50,000 | 2–4 hrs | 4–6 day stay |
| Robotic / TECAB (selected cases) | £35,000–£60,000 | 4–6 hrs | 4–6 day stay |
| Hybrid revascularisation (LIMA-LAD + PCI) | £25,000–£45,000 | Staged | 3–5 day stay |
| Consultation and MDT review | £300–£600 | 45 min | Same visit |
Prices vary by surgeon, hospital, number of grafts, whether the operation is on- or off-pump, and by ICU length of stay. Insurance typically funds CABG in full when medically indicated. We come back with a firm quote within one working day.
The problem
CABG or PCI? The right answer for your anatomy, not the one nearest to hand.
Revascularisation decisions belong at MDT, framed by SYNTAX and STS scores, LV function, diabetes and comorbidities — not by whichever specialist saw you first.
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Been told you need bypass?
A second opinion at MDT is standard practice — we arrange it, without pressure and without cost.
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Angiogram sitting in a folder?
Send it. A surgeon and a cardiologist review the images together and come back with a genuine recommendation.
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PCI has failed once already?
Repeated stenting is not always the right answer. Sometimes a LIMA to LAD gives you decades of durable revascularisation.
The journey
MDT decision, prehab, surgery, cardiac rehab.
One clinician from first message to twelve-week rehab review — including the ICU stay and secondary prevention.
Phase 1 · Before surgery
MDT, workup and prehab
Phase 2 · In hospital
Theatre, ICU and ward
Phase 3 · After
Rehab and follow-up
- 01
Before
You tell us what is going on
A short, confidential summary of your symptoms, angiogram and any prior PCI. Angina pattern, breathlessness, and known LV function all matter.
- 02
Before
MDT decision, not a sales pitch
Cardiologist and surgeon review your anatomy together — SYNTAX and STS scores, LV function, diabetes, comorbidities. CABG vs PCI vs hybrid is decided on evidence, not on who saw you first.
- 03
Before
Prehab and workup
Bloods, ECG, echo, carotid dopplers where indicated, and a prehab window — smoking cessation, glycaemic control, iron, and physio. Antiplatelets are managed with the team.
- 04
In hospital
Admission and anaesthetic
Admission the day before or on the morning. GA with the cardiac anaesthetic team; lines, TOE and full monitoring in a dedicated cardiac theatre.
- 05
In hospital
The operation itself
Three to five hours. LIMA harvested and grafted to the LAD; additional conduits (RIMA, radial, SVG) as planned. On-pump with the heart–lung machine, or off-pump (OPCAB), or MIDCAB via a mini-thoracotomy.
- 06
In hospital
ICU, then the ward
Extubation within hours, one to two nights in cardiac ICU, then step-down. Chest drains out at 24–48 hours; mobilising by day two.
- 07
After
Rehab and review
Hospital stay five to seven days. Cardiac rehabilitation over six to twelve weeks, with a surgical review at four to six weeks and a cardiology review to confirm secondary prevention.
Typical end-to-end: 2–6 weeks from enquiry to operation. Full recovery and cardiac rehab: 6–12 weeks.
When it helps
When CABG is the right operation.
The anatomies and clinical situations that push the MDT toward surgery — and the one red flag that means an emergency, not an outpatient booking.
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Left main stem disease
Significant stenosis (≥50%) of the left main coronary artery — historically a strong indication for CABG, with hybrid or PCI selected in specific anatomies.
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Triple-vessel disease
Significant disease in all three main coronary territories, especially with a high SYNTAX score, diabetes, or reduced LV function.
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Diabetes with multivessel disease
FREEDOM-era evidence favours CABG over PCI for diabetic patients with multivessel disease and suitable anatomy.
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LV dysfunction with viable myocardium
Reduced ejection fraction with evidence of hibernating but viable myocardium — surgical revascularisation can improve function and prognosis.
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Complex anatomy unfavourable for PCI
Long, calcified, bifurcation or chronic total occlusion lesions where PCI is technically difficult or unlikely to give durable results.
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Failed or recurrent PCI
In-stent restenosis or repeated PCI failure in an anatomy suited to bypass — surgery gives a fresh conduit around the diseased segment.
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Concomitant valve or aortic surgery
Coronary disease found alongside significant valve disease or an aortic aneurysm — a single combined operation is often the right answer.
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Red flag: unstable angina at rest
Chest pain at rest, at night, or crescendo angina is an emergency — same-day A&E, not an outpatient booking.
Options and conduits
CABG is not one operation.
What each approach and conduit actually involves — and which fits which anatomy and comorbidity profile.
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On-pump CABG
The standard operation: full sternotomy, cardiopulmonary bypass and a still, decompressed heart. Reliable, reproducible, and the benchmark against which everything else is judged.
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Off-pump CABG (OPCAB)
Grafts placed on the beating heart, avoiding the bypass circuit. Considered case by case — particularly for patients with heavily calcified aortas or higher stroke risk.
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MIDCAB (mini-thoracotomy)
A small left-anterior thoracotomy for a LIMA-to-LAD graft without splitting the sternum. Faster recovery for single-vessel LAD disease.
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Robotic / TECAB
Totally endoscopic coronary bypass with a surgical robot. Highly selected cases, evolving evidence, done in specialist centres.
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LIMA to LAD (gold standard)
The left internal mammary artery to the left anterior descending — the graft with the best long-term patency, used in almost every CABG.
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Additional arterial conduits
Right internal mammary (RIMA) and radial artery grafts. Better long-term patency than vein where anatomy allows, at the cost of longer operating time.
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Saphenous vein grafts (SVG)
Harvested from the leg for additional targets. Reliable in the short and medium term; graft attrition and SVG failure become important at five to ten years.
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Hybrid revascularisation
LIMA to LAD surgically, plus PCI to the other territories. Combines the durability of the LIMA graft with the less invasive nature of stents.
Our vetted London network
A small panel of cardiothoracic surgeons, we picked them.
Consultant cardiothoracic surgeons across central London’s major private cardiac units. Not listed publicly — introductions are made privately, once the MDT has framed your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant cardiothoracic surgeons on the GMC specialist register, not trainees
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Formal cardiology–surgery MDT for every revascularisation decision
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On-pump, off-pump, MIDCAB and hybrid options genuinely available
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Cardiac rehabilitation and secondary prevention arranged before discharge
Safety and recovery
The complications worth knowing about — honestly.
CABG is one of the most studied operations in medicine. The risks are real and quantifiable — your STS score gives an individualised estimate discussed at the MDT.
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Bleeding and return to theatre
Post-operative bleeding is common; a small proportion of patients need to return to theatre in the first 24 hours. The team is set up for this and it is not a failure of the operation.
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Sternal wound infection and mediastinitis
Superficial wound infections are uncommon; deep sternal infection (mediastinitis) is rare but serious. Diabetes, obesity and smoking increase the risk — prehab matters.
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Stroke
Peri-operative stroke risk is roughly 1–2%, driven by aortic atheroma, embolism from the bypass circuit and patient factors. Off-pump technique is considered where stroke risk is high.
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Acute kidney injury
Some post-operative AKI is common; a small number of patients need short-term dialysis. Pre-existing kidney disease is the main predictor.
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Post-operative atrial fibrillation
AF affects 20–40% of patients in the first week — usually transient, treated with rate control and anticoagulation, and gone by the time you go home.
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Peri-operative MI
A small rise in troponin is expected; a true peri-operative myocardial infarction is uncommon and picked up on ECG, TOE and enzymes in ICU.
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Cognitive dysfunction
Some patients notice slower thinking or word-finding in the weeks after surgery. It usually settles; a small minority notice a longer-term change.
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Graft occlusion over years
LIMA grafts have excellent long-term patency. Saphenous vein grafts have meaningful attrition at five to ten years — the reason secondary prevention and lipid control matter for life.
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Red flags after discharge
Fever, spreading sternal redness, sternal clicking or instability, sudden breathlessness, calf swelling or recurrent chest pain are reasons to seek same-day medical help.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and heart-team decision
The clinical reason for surgery — left main, triple-vessel, diabetic multivessel — and the SYNTAX / STS scores that framed the MDT decision.
- 02 Technique
Approach, pump and conduits used
Sternotomy or mini-thoracotomy, on-pump or off-pump, and every conduit used with its target (LIMA to LAD, RIMA to Cx, radial to RCA, SVG to OM, etc.).
- 03 Findings
Bypass time, cross-clamp and issues
Cardiopulmonary bypass and cross-clamp times, any intra-operative issues, and the state of the target vessels at the time of grafting.
- 04 Impression
Recovery plan, rehab and medications
Read this first: expected recovery timeline, cardiac rehab referral, and the secondary prevention (aspirin, statin, ACEi, beta-blocker) that must continue for life.
Recognised by major UK insurers
CABG is typically funded in full by UK insurers when medically indicated. We confirm cover, excess and any co-payments before booking.
Frequently asked
Everything patients ask us about CABG.
Quick answers on CABG vs PCI, recovery, complications, and what secondary prevention actually means.
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How soon can I have a private coronary artery bypass in London?
Most elective CABGs go to theatre within two to three weeks of a heart‑team MDT confirming the plan — sooner if symptoms are unstable or the anatomy is left‑main. Expect five to seven nights in hospital, cardiac rehab across six to twelve weeks, and DVLA clearance to drive at four weeks for a standard licence.
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On-pump or off-pump — which is better?
On-pump CABG is the reproducible benchmark and remains the default in most units. Off-pump (OPCAB) avoids the bypass circuit and can be preferred in patients with a heavily calcified aorta or higher stroke risk. Long-term graft patency slightly favours on-pump in most randomised data; the choice is individualised.
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What is MIDCAB and who is it for?
Minimally invasive direct coronary artery bypass — a LIMA to LAD graft done through a small left-anterior thoracotomy without splitting the sternum. It suits patients with isolated LAD disease and is often used as the surgical half of a hybrid procedure.
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What is a hybrid revascularisation?
The LIMA is grafted to the LAD surgically (usually via MIDCAB) and the other diseased vessels are treated with stents (PCI). It combines the durability of the LIMA graft to the LAD with the less invasive nature of PCI for the other territories.
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How long is the recovery from CABG?
ICU for one to two days, hospital stay of five to seven days, and cardiac rehabilitation over six to twelve weeks. Driving usually resumes at four to six weeks (check your DVLA and insurance rules), and most patients are back to normal activity by three months.
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How common is post-operative atrial fibrillation?
Very common — 20–40% of patients in the first week. It is usually transient, treated with rate control and short-term anticoagulation, and gone by the time you leave hospital.
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How long do the grafts last?
LIMA to LAD is exceptional — patency well over 90% at ten years in most series. Radial and RIMA grafts do very well in the right anatomy. Saphenous vein grafts have meaningful attrition, with roughly half occluded or diseased at ten years — the reason secondary prevention is lifelong.
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What are the main risks of CABG?
Bleeding requiring re-operation, sternal wound infection or mediastinitis, stroke (roughly 1–2%), acute kidney injury, peri-operative MI, cognitive dysfunction and, in a small number, death. Your STS score gives an individualised estimate discussed at the MDT.
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Do I still need medication after CABG?
Yes, for life. Antiplatelet therapy (usually aspirin), a high-intensity statin, blood-pressure control, an ACE inhibitor and often a beta-blocker are all part of secondary prevention. Stopping them is the commonest reason grafts fail early.
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When should I go to A&E after CABG?
Fever, spreading redness around the sternal wound, sternal clicking or instability, sudden breathlessness, calf swelling, or recurrent chest pain — any of these warrant same-day medical review.
Related tests and treatments
Looking for something else?
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Coronary angioplasty (PCI)
Stenting as the alternative or complement to CABG.
Learn more -
CT coronary angiography
Non-invasive imaging of the coronary arteries.
Learn more -
Pressure wire study (FFR/iFR)
Functional assessment of coronary lesion severity.
Learn more -
All tests and treatments
Every test and procedure we arrange.
Learn more -
Hypertension
Related condition guide.
Learn more -
Atrial Fibrillation
Related condition guide.
Learn more -
ECG
Related diagnostic test.
Learn more -
Echocardiogram
Related diagnostic test.
Learn more
In practice, in London
How coronary artery bypass tends to unfold when you go private
For coronary artery bypass, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. Public provision for coronary artery bypass is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For coronary artery bypass in particular, we bias towards consultants who do this every week rather than every month.
There are a lot of consultants in London who can technically handle coronary artery bypass. Fewer who do it week in, week out for the exact question you’re bringing. We spend most of our time working out which is which — and being straight when a different test or a different specialist would serve you better. Everything runs to CQC, GMC and Royal College standards; the choice is about fit, not floor.
Nearby in the library