Endoscopic coronary artery bypass surgery
What is endoscopic coronary artery bypass surgery?
Endoscopic coronary artery bypass surgery is a major heart operation that helps redirect blood around and throughout blocked arteries in the heart. A healthy blood vessel (a vein or an artery) is taken from either the patient's leg, arm or chest. The specialist performing the surgery will then connect this vessel both below and above the blocked arteries in the patient's heart to restore normal blood flow.
Why might someone require endoscopic coronary artery bypass surgery?
If a patient is experiencing chest pain on a regular basis, then they should certainly consider undergoing an endoscopic coronary artery bypass operation.The goal of endoscopic coronary artery bypass surgery is to improve blood flow to the heart and to alleviate chest pain. It is also performed to treat coronary heart disease.
How exactly is the surgery performed?
This would depend on the type of surgery that is performed. Totally endoscopic coronary artery bypass surgery is performed through four to five fingertip-sized slits with the help of the da Vinci surgical system. Beating heart coronary heart bypass surgery, on the other hand, is performed whilst the heart is still beating and does not require the assistance of a heart-lung bypass machine.
There are also two types of minimally invasive beating heart coronary heart bypass surgery: minimally-invasive direct coronary artery bypass (MIDCAB) and off-pump coronary artery bypass (OPCAB).
MIDCAB:
If the patient decides to undergo a minimally invasive direct coronary artery bypass operation, they will not need the help of a heart-lung bypass machine to keep their heart beating during the procedure. A doctor will also cut smaller incisions in the chest to gain access to the coronary arteries. In traditional endoscopic coronary artery bypass surgery, one large incision is made. Smaller incisions only expose the areas of the arteries that need grafts, instead of the whole heart in a traditional endoscopic coronary artery bypass surgery.
OPCAB:
Off-pump coronary artery bypass is a type of minimally invasive coronary artery bypass surgery that requires a smaller incision than the traditional method. It doesn't require the use of a heart-lung bypass machine. During an off-pump coronary artery bypass procedure, the cardiovascular surgeon will take a vein or an artery from another area of the body and use that vessel to bypass the blocked vessel to restore normal blood flow.
Preparation
A doctor and treatment team will explain to the patient what they can expect before, during and after surgery and what the potential risks of the surgery are. A doctor and their team will discuss any concerns that patients may have about the surgery. Patients may also need to have hair shaved from the areas of the body where the procedure will take place.
Aftercare following minimally invasive coronary bypass surgery
Recovery after minimally invasive coronary bypass surgery is less intense compared to a traditional endoscopic coronary artery bypass surgery. A patient can spend approximately five days in the hospital recovering from the minimally invasive procedure. Once a patient is discharged, they will not be able to drive home and should take it easy until they have a doctor’s clearance. Patients are recommended to have a follow-up appointment within a week of their surgery.
Recovery may take a few weeks, as patients gradually regain strength. They may be offered a cardiac rehabilitation programme to help them safely and gradually get back to normal activities.
What alternative treatments are available?
An efficient and possible alternative to endoscopic coronary artery bypass surgery is full sternotomy coronary artery bypass graft surgery in selected patients.
Which specialists perform this type of surgery?
Cardiologists and cardiothoracic surgeons are responsible for performing all types of coronary artery bypass surgery.