Advancing Quality NHS Advancing Quality Alliance

Heart Bypass

Heart Bypass Surgery is a surgical procedure performed to reduce the risk of death from heart attacks and heart disease. Arteries or veins from elsewhere in the patient’s body are grafted to the coronary arteries to bypass narrowed veins and improve the blood supply to the heart muscle.

The procedure is often referred to as Coronary Artery Bypass Graft or CABG (pronounced in the same way as the vegetable; cabbage).

Through research, clinical input and clinical guidelines Advancing Quality has developed seven measures that, when applied at the appropriate time, can greatly increase the outcomes for patients. Advancing Quality uses these measures to monitor the quality of care given to patients across the North West with the aim of improving standards and reducing variation in care.


1. Appropriate antibiotics up to one hour before surgery

It is important that you receive the right antibiotic for you and for the type of surgery you are having to stop you getting an infection.

2. Appropriate antibiotics selected to prevent infection

It is important that you receive the antibiotic up to an hour before surgery as it can reduce the risk of infection by 50%.

3. Appropriate antibiotics stopped within 24 hours after your operation

It is best to take antibiotics for a short a time as possible. There is no benefit for you in carrying on with antibiotics 24 hours after surgery.

4. Use of internal mammary artery for graft

A graft allows blood to flow around a blocked or damaged area of the heart. A graft to the internal mammary artery has better outcomes which last longer.


In human anatomy, the internal thoracic artery (ITA), previously known as the internal mammary artery (a name still common among surgeons ), is an artery that supplies blood to the anterior chest wall and the breasts.

5. Surgical checklist completed (Introduced Y6)

When the surgical team use a surgical checklist it reduces the chance of surgical errors and improves your safety through best-practice

6. Blood thinning medication when you leave hospital (Introduced Y6)

You may be asked to take this medication as it will help manage any pain you have and also reduce the risk of getting a blood clot.

7. Cholesterol reducing medication when you leave hospital (Retired Y6)

Statins are a medication that reduce blood cholesterol. Lower cholesterol reduces the risk of you having a heart attack after surgery
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