Definition:
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart. It helps fix problems caused by coronary artery disease (CAD), in which the arteries that lead to your heart are partly or totally blocked. Minimally invasive coronary (heart) artery bypass can be done without stopping the heart and putting a patient on a heart-lung machine. See also:
Alternative Names:
Minimally invasive direct coronary artery bypass; MIDCAB; Robot assisted coronary artery bypass; RACAB; Keyhole heart surgery
Description:
A heart surgeon will make a 3- to 5-inch-long incision (cut) in the left part of your chest between your ribs. This allows the surgeon to reach your heart. Muscles in the area will be pushed apart. A small part of the front of the rib, called the costal cartilage, will be removed. Then the surgeon will find and prepare an artery in your chest to attach to your coronary artery that is blocked. Once the above steps are done, the surgeon will connect the prepared chest artery to your coronary artery that is blocked. You will not need to be on a heart-lung machine for this surgery, but a device will be attached to your heart to slow it down.
Why the Procedure Is Performed:
Coronary arteries are the small blood vessels that supply your heart with oxygen and nutrients that are carried in your blood. When one or more of the coronary arteries becomes partly or totally blocked, your heart does not get enough blood. This is called ischemic heart disease or coronary artery disease. It can cause chest pain (angina). Coronary artery bypass surgery can be used to treat coronary artery disease. Your doctor may have tried to treat you with medicines only. You may have also tried cardiac rehabilitation. Coronary artery disease varies a lot from person to person, so the way it is diagnosed and treated will also vary. Heart bypass surgery is just one treatment. It will be right for some people, but others may have other kinds of treatment. Minimally invasive coronary artery bypass may be used when only 1 or 2 coronary arteries need a bypass and they are located around the front of the heart.
References:
Aziz O, Rao C, Panesar SS, Jones C, Morris S, Darzi A, et al. Meta-analysis of minimally invasive internal thoracic artery bypass versus percutaneous revascularisation for isolated lesions of the left anterior descending artery. BMJ. 2007;334:617. Ferraris VA, Mentzer RM Jr. Acquired heart disease: coronary insufficiency. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 61. Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007 Dec 4;116(23):2762-72. Epub 2007 Nov 12.
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