Are there other types of bypass surgery?
Standard bypass surgery involves stopping the heart for 30-90 minutes while the functions of the lungs and heart are performed by a heart-lung machine. The heart is accessed by splitting the breastbone (sternum) and opening the chest cavity to fully expose the heart. For some patients, less invasive forms of bypass surgery may be performed to avoid some of the complications associated with traditional bypass surgery.
What is off-pump bypass surgery?
Beating heart, also known as off-pump, bypass surgery is performed without stopping the heart, making the heart-lung machine unnecessary. The parts of the heart muscle where the healthy vein or artery is sewn are held motionless by stabilizing devices, allowing the heart to continue to pump blood during the surgery. The off-pump approach is an important advance because use of the heart-lung machine increases the risk of complications such as stroke, heart attack, and kidney damage, and increases the need for blood transfusion. In 2002, 22% of bypass surgeries were performed using beating heart techniques.20 Off-pump surgery may also reduce the risk of death following surgery; a study of nearly 17,000 women found that those who underwent off-pump surgery had a 42% lower risk of death compared with those who had standard bypass surgery.21 In addition, off-pump surgery helps reduce the time spent in the hospital. This is especially important for women, who tend to require longer hospital stays than men after traditional bypass. Some studies also suggest that women who undergo off-pump surgery are less likely to experience mental confusion, memory loss, and stroke.
What is MIDCAB?
Minimally invasive direct coronary artery bypass surgery (MIDCAB) is another method to reduce the trauma associated with bypass surgery. In MIDCAB, surgeons access the heart through small incisions between or under the ribs. This type of surgery is also performed without stopping the heart. Smaller incisions mean that patients can recover more quickly after surgery. However, not all parts of the heart can be accessed using these small incisions, so patients who have many blockages or blockages on hard-to-reach areas of the heart may not be eligible for this type of surgery.
What is “hybrid” surgery?
Blockages in certain arteries of the heart, especially the large artery on the left side of the heart, are best treated with bypass surgery to ensure good long-term blood flow. However, in other areas of the heart, angioplasty or stenting may work as well as bypass. To provide the fastest recovery while ensuring the best results for the patient, a new technique called hybrid revascularization is being developed that combines bypass surgery with angioplasty. In hybrid surgery, a bypass graft (a vessel from another part of your body) is used to re-route blood around the blockage in the largest artery, and the other blockages are treated with angioplasty or stents. Although this procedure is still considered experimental, preliminary studies suggest that it may provide the same results as bypass surgery while reducing recovery time and postoperative pain.22
