When coronary disease can not be mitigated by angioplasty and stents, or if other diseases such as diabetes are present, coronary artery bypass grafting (CABG) may be the most appropriate option.
Coronary artery bypass grafting is an invasive “open heart surgery” procedure that improves blood flow to the heart. While CABG is more invasive procedure than angioplasty or stenting, long-term results are improved. The traditional CABG involves an incision that divides the breastbone, known as a sternotomy. This allows the surgeon access to the heart.
During surgery, a vein is often taken from the leg using video technology, through a tiny incision near the knee. Veins and arteries are then attached to the coronary arteries beyond the blockages, allowing blood to divert around the blockage. Frequently, an artery may be taken from the wall of the chest to carry out a bypass.
Next, the surgeon puts the patient on the bypass machine, emptying blood from the heart, filtering and oxygenating the blood, and then returning it to the patient. Use of the bypass machine allows the surgeon to perform the bypasses on a still (non beating) heart.
Once the bypasses have been completed, the patient is taken off the bypass machine, the patient’s heart is restarted, the sternal bone is repaired, and the surgical incisions are closed. The surgery generally takes about two or three hours. Afterwards, the patient goes to the intensive care unit to recover.
Minimally Invasive Options
It is possible to carry out a CABG operation through a small incision (usually about 3″) on the left side of the chest. When only one or two bypasses are required, the minimally invasive route may be a good option for you.
With the assistance of a surgical robot like the da Vinci system, an artery is removed from the inside wall of the chest, allowing the surgeon better visualization of the procedure, as well as greater dexterity. Robotically assisted surgery generally causes less trauma for the patient and frequently allows the procedure to be performed without the use of a bypass machine. The minimally invasive option also allows for less scarring (better cosmesis cosmetic results), quicker recovery time, and less risk of infection or bleeding post-operatively.
If you have questions about coronary artery bypass grafting, or to find out if you are a candidate for minimally invasive robotic surgery, please contact us.