Coronary Artery Bypass Graft Surgery
Coronary artery disease causes the arteries that carry oxygen and blood to the heart to narrow and harden. If the arteries become clogged or blocked, the blood supply to the heart decreases. This reduces the amount of oxygen available to the heart, leading to heart failure or heart attack.
Coronary artery bypass graft (CABG) surgery is a procedure that creates a new pathway around the blockage to restore proper blood flow to the heart. During surgery, a healthy section of a vein is removed from the leg, or a piece of an artery is taken from the wrist or chest. The heart surgeon then attaches a piece of healthy blood vessel taken from another area of the body (called a graft) above and below the damaged area. This allows blood to flow around the blockage. More than one bypass may be needed if there is more than one blocked area.
The heart surgeons at Orlando Health Heart & Vascular Institute offer treatment backed by years of experience, advanced expertise, and mastery of the latest technology that provides comprehensive, compassionate heart care to meet each patient's individual needs.
There are several types of coronary bypass graft surgery. The conventional open chest procedure is commonly done, but less invasive techniques may also be a viable option for many patients.
On-pump coronary artery bypass (ONCAB) is the traditional method of heart surgery. The procedure takes place while the patient’s heart is stopped and requires the use of a ventilator and a cardiopulmonary bypass machine known as a heart-lung machine.
During ONCAB, medication is used to safely stop the heart and provide the nourishment it needs during the operation. The chest and rib cage are separated to allow access and bypass grafts are taken from other areas of the body for use in the heart. Once the grafts are attached and the heart is restarted, the heart-lung machine and ventilator are disconnected to allow the heart and lungs to resume their normal functions.
Off-pump coronary artery bypass (OPCAB) requires a high level of surgical skill. The procedure is done without stopping the heart or using a heart-lung machine. Instead, a mechanical device is used to steady the heart and allow the surgeon to construct the bypass grafts while it continues to beat. The surgery may be done through a conventional open-chest method or with more minimally invasive surgical techniques, depending on the surgeon's assessment of the patient's needs.
Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)
Minimally invasive direct coronary artery bypass (MIDCAB) is typically used for patients with one heart blockage. The procedure uses a small incision made between two ribs and does not require cutting the breastbone to open the chest. During the operation, the heart continues to beat, and a heart-lung machine is not needed.
Hybrid Coronary Revascularization
Hybrid coronary revascularization is a procedure that allows patients with more than one blockage to take advantage of the minimally invasive approach of MIDCAB surgery. During the surgery, MIDCAB is used to bypass major blockages with a graft. Tubes called stents are used to open other blocked areas and restore proper blood flow to and from the heart.