Quadruple Heart Bypass Surgery
A quadruple heart bypass surgery, or coronary artery bypass grafting, helps restore healthy blood flow to your heart. At The Keyhole Heart Clinic, our heart surgeons have refined safe, minimally invasive techniques over more than 20 years.
Our keyhole approach to treating coronary artery disease helps reduce significant recovery time and discomfort compared to traditional open-heart surgery.
ASSOCIATED CONDITIONS
KEYHOLE SURGERY
- Coronary Artery Bypass Graft (CABG) Keyhole Surgery
- Keyhole Aortic Valve Replacement Surgery
- Keyhole Atrial Septal Defect (ASD) Repair
- Keyhole Mitral Valve Replacement & Repair Surgeries
- Keyhole Tricuspid Valve Repair & Replacement Surgery
- Quadruple Heart Bypass Surgery
- Triple Bypass Surgery
HEART CONDITIONS
What is Quadruple Bypass Surgery?
A quadruple bypass surgery procedure is also known as:
- Coronary artery bypass grafting (CABG), pronounced cabbage
- Quadruple heart bypass surgery
- Quad bypass surgery
Keyhole coronary bypass surgery restores blood flow to the heart by creating new routes around narrowed or blocked arteries. These pathways are often described as “flyovers”.
The terms double bypass, triple bypass, and quadruple bypass describe how many heart arteries need to be rerouted during surgery: 2, 3, or 4, respectively.
Multiple bypasses don’t always reflect how severe your heart disease is. It simply depends on your heart’s anatomy and the location of the blockages.
Why You Might Need a Quadruple Bypass
Your doctor may recommend coronary artery bypass grafting if you have severe coronary artery disease, blockages in several major arteries, or if stenting isn’t expected to give long-lasting results.
By improving blood flow, bypass surgery can:
- Reduce the risk of heart attacks and heart failure
- Relieve symptoms such as chest pain or fatigue
- Improve quality of life
- Extend life expectancy
What to Expect from Coronary Artery Bypass Grafting
Heart bypass surgery can be done in two ways: traditional open-heart surgery or a minimally invasive “keyhole” approach using small incisions. At the Keyhole Heart Clinic, we are experienced in both.
Here is what happens during surgery:
1. Preparing for Surgery
You’ll be put under general anaesthesia. While you’re asleep, the surgical team will place a breathing tube and monitors to track your heart rate and blood pressure. You won’t feel anything during either procedure.
2. Reaching Your Heart
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Keyhole approach: Your surgeon makes several small incisions between your ribs and uses a tiny camera and specialised tools to perform the surgery.
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Traditional approach: Your surgeon makes one incision down the centre of your chest and breaks your breastbone open to reach your heart.
3. Harvesting the Graft Vessels
Rather than removing the blocked arteries, your surgeon harvests healthy blood vessels from other parts of your body to bypass the blockage. These are typically:
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The left internal mammary artery (from behind the chest wall)
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The radial artery (from the forearm)
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The saphenous vein (from the leg)
Arterial grafts generally last longer than veins, so they’re used whenever possible.
4. Protecting Your Heart During Surgery
You’ll receive medication to prevent blood clots.
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For most traditional open-heart surgeries, a heart-lung machine safely pumps an oxygen-rich blood supply throughout the body while the heart is at rest.
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With keyhole techniques, surgery can often be done while your heart continues beating.
5. Creating Your New Blood Pathways
Your surgeon connects the healthy blood vessels to your heart arteries, routing blood around the blockages. Blood can now flow freely to nourish your heart muscle. The other end of each vessel is connected to your aorta (main artery) or another suitable blood vessel.
6. Getting Your Heart Back to Work
If the heart-lung machine is used, your surgical team will restart your heart and restore normal blood flow. They’ll check each new bypass to ensure your heart is working properly.
7. Closing Up
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Keyhole surgery: The small incisions are closed with dissolving stitches.
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Traditional surgery: Your breastbone is secured with strong, permanent wires, and your chest incision is closed with dissolving stitches.
After Your Heart Surgery
You’ll wake up in the intensive care unit for monitoring during early recovery. Cardiac rehabilitation will play an important role in your recovery, helping you regain your ability to enjoy life with a significantly healthier heart.
Following the surgical procedure, you may need to make crucial lifestyle changes, such as following a Mediterranean-style diet and engaging in regular physical activity.
Quadruple Coronary Bypass Surgery Risks
While quadruple cardiac bypass surgery is a standard and often life-saving procedure, like all major surgeries, it carries risks. Some are related to the procedure itself, while others depend on your overall health and medical condition.
General risks include:
- Stroke
- Death
Common post-surgery complications:
- Fluid buildup in the chest
- Longer surgery times
- Worsening chest pain before surgery
- Deep wound infections. Most side effects are more commong with traditional open-heart surgery than with keyhole approaches.
Risk factors for complications during the surgical procedure include:
- Older patients face a higher risk of stroke, complications and longer recovery.
- Frailty or poor physical condition
- Poorly controlled diabetes
- Chronic lung disease
- Other conditions, like liver disease
- Peripheral arterial disease (reduced blood flow to limbs)
- Low body weight
- Previous heart attack with scarring
UK First in Keyhole Quad Bypass Surgery
Mr Birdi, Director of the Keyhole Heart Clinic, is one of the few surgeons worldwide qualified to perform complex cardiac procedures, such as keyhole coronary artery bypass surgery and keyhole aortic valve restoration.
In 2022, he made history by carrying out the UK’s first quadruple heart bypass using minimally invasive keyhole surgery.
Watch the patient tell his story in his own words.
Benefits of Keyhole Surgery
With the expertise of an experienced heart surgeon like Mr Birdi, the benefits of the keyhole method over traditional open-heart surgery include:
- Minimal surgical trauma
- Reduced the risk of infection
- More minor, less noticeable scars
- Faster recovery time
- Reduced pain
- Lower risk of infection
Coronary Artery Bypass Techniques
At The Keyhole Heart Clinic, we’ve helped refine Total Coronary Revascularisation via Anterior Thoracotomy (TCRAT). This keyhole technique allows multi-vessel bypass surgery, including triple and quadruple bypasses, through a single small incision.
Also called Multi-MIDCAB, this technique treats coronary disease in multiple arteries and features:
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5–8 cm incision on the left side of the chest, between the ribs
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Access to all major coronary arteries without splitting the breastbone
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Performed with specialised instruments and video-assisted technology for precision
This highly complicated procedure is offered by only a few surgeons worldwide, including our clinic director and lead surgeon, Mr Birdi.
Your team will recommend the most suitable treatment for your specific condition. Other options, which are usually less suitable for surgery with multiple bypasses, include:
Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)
MIDCAB is used when one coronary artery needs bypassing, typically the left anterior descending artery (LAD).
Technique:
- Small incision (6-10 cm) between ribs on the left side of the chest.
- Left internal mammary artery (LIMA) used as a bypass graft
- Usually performed on a beating heart, avoiding the heart-lung machine
Hybrid Keyhole Heart Bypass Surgery
For patients not suitable for Multi-MIDCAB, this combines surgical and interventional approaches:
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MIDCAB procedure for LAD
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Stent placement for the remaining narrowed arteries
While clinical trials are limited, preliminary research has shown that hybrid keyhole surgery offers:
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Reduced in-hospital major complications
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Fewer blood transfusions and chest drainage
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Shorter hospital stays
This approach avoids breastbone division while providing comprehensive treatment.
Coronary Stent Insertion
A catheter-based procedure for some isolated coronary artery diseases. This non-surgical procedure is highly effective in emergencies to prevent heart attack damage.
Technique:
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Catheter inserted via wrist or groin vessel
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Balloon inflates the diseased area
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A stent holds the heart artery open
Limitations:
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Stents can block over time, causing symptom recurrence
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Surgery often provides better long-term results for multiple lesions and high-grade proximal disease
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The Keyhole Heart Clinic: Expert Private Care
The Keyhole Heart Clinic offers modern solutions for heart conditions with care and precision. Our clinic is led by Mr Inderpaul Birdi, a Cardiothoracic Surgeon with over twenty years of experience in keyhole cardiac procedures.
He specialises in keyhole techniques, which often result in shorter recovery times and improved outcomes. These include:
- Keyhole mitral valve repair or replacement surgery
- Keyhole tricuspid valve replacement
- Keyhole aortic valve replacement
- Keyhole atrial fibrillation ablation
- Keyhole atrial septal defect closure
We also offer complete heart screening services.
Book an appointment with an innovator in quadruple heart bypass surgery to improve your quality of life, or contact us for more information.
Services
How We Can Help You
Coronary Artery Bypass Graft (CABG) Keyhole Surgery
Keyhole Aortic Valve Replacement Surgery
Keyhole Atrial Septal Defect (ASD) Repair
Keyhole Mitral Valve Replacement & Repair Surgeries
Keyhole Tricuspid Valve Repair & Replacement Surgery
Quadruple Heart Bypass Surgery
