Coronary Artery Bypass Grafting (CABG)

Coronary bypass is one of the most common reasons people travel to South India for surgery, and it is also one of the least suitable for a rushed decision. If a cardiologist has recommended bypass rather than stenting, that recommendation came out of your angiogram and your particular pattern of disease. Nothing on this page changes that, and it is not intended to. What it does is set out what travelling for the operation actually involves, so you can plan realistically.

What the operation involves

In general terms, bypass surgery restores blood flow past narrowed sections of the coronary arteries by grafting a healthy vessel — usually taken from the chest wall, the arm or the leg — to carry blood around the blockage. The number of grafts depends on how many vessels are affected, which is what people mean by a double or triple bypass.

Some patients are suitable for off-pump or "beating heart" surgery, where the heart-lung machine is not used; others are not, and that judgement belongs to the surgeon after reviewing your angiogram and echocardiogram. Minimally invasive approaches exist for certain patterns of disease. Which applies to you is a clinical decision, not a menu option, and any facilitator who tells you otherwise before a surgeon has seen your films is guessing.

Why the trip takes as long as it does

The indicative range for bypass is around two to three weeks in India. That figure surprises people who expect surgery plus a few days, so it is worth breaking down.

Before surgery — two to four days. Even with reports sent ahead, the hospital repeats key investigations on arrival: bloods, a chest X-ray, an echocardiogram, sometimes a repeat angiogram if yours is not recent. You will see the surgeon and an anaesthetist. Dental review is routine before cardiac surgery, because an untreated infection is a genuine risk, and occasionally that finds something that needs dealing with first.

Hospital stay — around a week. Typically a night or two in intensive care followed by several days on a cardiac ward, with mobilisation and breathing exercises starting early.

After discharge — roughly a week before flying. This is the part almost everyone underestimates. You are not cleared to fly the day you leave the ward. There is a review period covering wound healing, rhythm checks, and adjusting medication, and cardiac surgery patients are generally advised to wait before a long flight. Your surgeon signs off the fit-to-fly decision, not your airline and not us.

Plan for the upper end of the range rather than the lower. If you are discharged early, you have gained a few days; if you booked tightly and recovery takes the time it normally takes, you are changing flights while unwell.

What the written estimate covers

Before you commit to anything, you receive an estimate naming the hospital, the consultant cardiac surgeon and their medical council registration number, the proposed procedure, an all-inclusive cost range from the hospital, and the number of days to plan for. It typically covers surgery, theatre and ICU time, consumables, the ward stay, standard investigations and physiotherapy. It does not cover flights or the visa fee.

Cardiac estimates carry more variability than most, because complications and extra ICU days genuinely cannot be priced in advance. A hospital giving you a single unqualified figure for bypass is not being more transparent than one giving you a range — it is being less.

Getting ready to travel

Bring the actual investigations, not summaries: your angiogram images on disc or via a shared link, echocardiogram report, ECGs, recent blood results, and a complete list of current medication with doses. If you are on blood thinners, say so at the very start — instructions about stopping or bridging them before surgery come from the surgical team and the timing matters.

Travel with someone. This is not a procedure to face alone, and the attendant visa exists for exactly this reason. Expect to be in India for the best part of a month if things run long, and arrange work and family commitments on that basis rather than on the optimistic version.

Questions worth asking the surgeon

You are entitled to ask these directly, and a good unit will answer them without defensiveness:

• How many grafts are you planning, and why that number?
• Are you recommending on-pump or off-pump, and what makes that the right choice for me?
• Which vessels will you use for the grafts?
• What would make you change the plan once you are operating?
• Who covers my care overnight and at weekends?
• What happens, and what does it cost, if I need longer in intensive care?

If you would like these asked on your behalf before you travel, we will put them to the unit in writing and send you the answers.

If something goes wrong

Facilitator websites almost never address this, which is itself worth noticing. Cardiac surgery carries real risk, complications happen in the best units in the world, and you should know the answers before you travel rather than while you are in an intensive care unit far from home.

Ask the hospital directly, and get it in writing: what happens if you need significantly longer in intensive care, whether extended stay is charged at a daily rate, who makes decisions if you are unable to, and what their process is if a complication requires a second operation. Reputable units answer these plainly. A unit that deflects is telling you something.

Understand also what we are and are not. We are a facilitator: we match you to a hospital, arrange the logistics and stay contactable. We do not provide medical care and we carry no clinical responsibility for it — your contract for treatment is with the hospital, and any clinical complaint or claim lies against them under Indian law. That is true of every facilitator, whether or not they say so. Ask us anything about the process and we will answer; ask us whether a surgeon made the right call and the honest answer is that we are not qualified to say.

Travel insurance rarely covers planned surgery abroad or its complications, and policies that do usually require declaration in advance. If you want that cover, arrange it before you travel — it cannot be bought retrospectively.

Comparing estimates properly

If you are getting quotes from more than one hospital or facilitator, compare them on the same basis or the exercise is worthless. Check whether the figure is a fixed price or a range, how many ICU days are assumed, whether it includes the pre-operative work-up and the post-discharge reviews, what happens to the price if the surgeon finds more disease than the angiogram suggested, and whether the named surgeon is the one who will actually operate.

The cheapest number is often the one with the most excluded. We would rather send you an estimate that looks higher and turns out to be accurate.

Recovery and going home

You leave with a discharge summary, operative notes, imaging, prescriptions and a follow-up schedule. Cardiac rehabilitation matters as much as the surgery, and most of it happens after you are home — we make sure the discharge documents are detailed enough for a cardiologist in your own country to pick up your care without starting from scratch.

Some patients choose to spend part of the recovery period in Kerala rather than flying immediately, which is one of the few genuine advantages of being treated in this particular region. Whether that is appropriate after cardiac surgery is a question for your surgeon, and we ask rather than assume.