Coronary artery bypass grafting (CABG) is a procedure for people who have severe blockages of the coronary arteries. The coronary arteries supply blood flow to the heart muscle. Two treatment options are available for people who have blockages: noninvasive stent placement or open bypass surgery.
Overview
Choosing which procedure to have is very important. It requires much discussion and teamwork among the cardiologist, surgeon, and patient. At M Health Fairview Heart Care, we ensure that this discussion happens after any coronary angiogram showing severe and complex coronary disease.
Our approach
The decision to undergo a major intervention on the coronary arteries can be life-saving, and choosing the right procedure can mean the difference between a long-lasting or short-lived result.
CABG can be done noninvasively through an incision in the leg or an open surgery that allows the surgeon to open long or complex blockages with a stent. For some blockages, bypass surgery is a better treatment than stents. Also, some blockages are best treated with medical intervention alone and no invasive procedures.
Coronary bypass surgery most often requires an incision in the chest that allows exposure through the sternum or breastbone. At the end of the procedure, this sternum is stabilized with multiple wires which significantly reduces pain and discomfort migration. This incision is one of the best tolerated in surgery and we have anesthetic pain programs to meet the needs of each individual.
During open heart surgery, the heart is connected to a heart-lung machine, which was pioneered at the University of Minnesota. For the graft, surgeons will use an artery that runs underneath the breastbone and a vein from the leg. Using a special camera device, the surgeon will make small cuts in the leg. For the right candidates, multiple arteries might be used to allow the longest-lasting result. Our surgeons’ goal is to provide blood flow to any and all critical vessels that require bypassing with the longest-lasting results possible and the safest outcome for the patient. A team of pain management specialists works with patients after CABG to reduce pain and make them as comfortable as possible.
Several hybrid procedures are available to treat severe coronary blockages, although this is less common. For instance, we may use a stent on some blockages while using surgery for an arterial bypass to the most critical blockage in the heart. These hybrid interventions are suited for select patients depending on anatomy and other medical problems. The robot is often used for these interventions to provide minimally invasive approach with the least amount of surgical intervention as possible.