Can bypass surgery help a weakened heart?

For some people with heart failure, bypass surgery can offer a path forward — even when the risks are higher.

When the heart isn't pumping as well as it should, everyday activities can feel exhausting. This condition, known as low ejection fraction, means the heart isn't moving blood through the body as effectively as it should.

For many, the cause is often coronary artery disease, a condition in which blocked arteries reduce blood flow to the heart muscle. When these two conditions occur together, treatment decisions can become more complex and increasingly important.

One treatment option may be coronary artery bypass grafting (CABG), commonly called bypass surgery.

Deciding who may benefit

Bypass surgery creates a new pathway for blood to flow around blocked arteries, helping improve circulation to the heart. But when the heart is already weakened, the procedure can be riskier.

That's why doctors take a personalized approach when determining whether bypass surgery is the right choice. They consider several factors, including:

• How well both sides of the heart are pumping

• The severity and location of blocked arteries

• Other health conditions, such as diabetes or kidney disease

• Overall patient condition

"When someone has both heart failure and blocked arteries, there's no one-size-fits-all answer," says Dr. Ankur Bakshi, a cardiothoracic surgeon with the Sharp Cardiovascular and Thoracic Center and affiliated with Sharp Memorial Hospital. "We look closely at the whole picture — how the heart is functioning, a person's overall health, and which treatment option is most likely to improve both quality of life and long-term outcomes."

Managing higher-risk cases

Certain conditions, including chronic kidney disease, diabetes and a significantly weakened heart, can increase the risk of surgery. Even so, some people may still benefit from bypass surgery, particularly when cared for by an experienced team of specialists.

In some cases, a patient may be referred to a heart failure specialist before surgery to discuss additional treatment options. These conversations can include medications that help improve heart function and lower surgical risk, as well as advanced therapies, such as a left ventricular assist device (LVAD), a mechanical pump that helps the heart circulate blood more effectively, or a heart transplant.

"Some people benefit from meeting with a heart failure specialist before surgery," says Dr. Bakshi. "Having those conversations early helps us explore every available option and create a treatment plan tailored to the patient's needs and goals."

By exploring all available treatment options beforehand, patients and their families can make informed decisions and feel more confident about the path forward.

Support during and after surgery

For individuals with more advanced heart weakness, temporary support devices may be used during or after surgery to help the heart pump blood while it recovers. The type of support depends on each person's individual condition and needs.

These tools, combined with careful planning and monitoring, can help improve outcomes, even in more complex cases.

"Today, we have more tools than ever to support people with advanced heart disease during and after surgery," says Dr. Bakshi. "These technologies can help the heart recover and give some patients access to treatments that may not have been possible in the past."

A personalized path forward

Learning that you have both heart failure and blocked arteries can feel overwhelming. But effective treatment options are available.

By combining thoughtful surgical planning, advanced therapies when needed, and a team-based approach, doctors can tailor care to each person. The goal is to help people move forward with greater confidence and hope.

"A diagnosis of heart failure can feel overwhelming, but there are often more treatment options available than people realize," says Dr. Bakshi. "Our goal is to help each person understand those options and feel confident about the path forward.

Learn more about cardiovascular care at Sharp Memorial Hospital, which has earned certification from The Joint Commission as a Comprehensive Cardiac Center; get the latest health and wellness news, trends and patient stories from Sharp Health News; and subscribe to our weekly newsletter by clicking the "Sign up" link below.