Heart By­pass Surgery

Wellness Update - - Meet Our Doctors -

Some­times coronary artery by­pass graft surgery (CABG) is the best op­tion for peo­ple with coronary artery disease. In this pro­ce­dure, sur­geons re­place dis­eased ar­ter­ies with healthy ones. Blood ves­sels re­moved from the chest, legs, or arms find a new home in the heart, keep­ing it well nour­ished. In coronary artery by­pass surgery, a healthy artery or vein from an arm, leg, or chest wall is used to build a de­tour around the coronary artery block­age. The healthy ves­sel then sup­plies oxy­gen-rich blood to the heart. By­pass surgery is ma­jor surgery. It is ap­pro­pri­ate for those pa­tients with block­ages in two or three ma­jor coronary ar­ter­ies, those with se­verely nar­rowed left main coronary ar­ter­ies, and those who have not re­sponded to other treat­ments. It is per­formed in a hospi­tal un­der gen­eral anes­the­sia. A heart-lung ma­chine is used to sup­port the pa­tient while the healthy vein or artery is at­tached past the block­age to the coronary artery. About 70% of pa­tients who have by­pass surgery ex­pe­ri­ence full re­lief from angina; about 20% ex­pe­ri­ence par­tial re­lief. Only about 3- 4% of pa­tients per year ex­pe­ri­ence a re­turn of symp­toms. Sur­vival rates af­ter by­pass surgery de­crease over time. At five years af­ter surgery, sur­vival ex­pectancy is 90%, at 10 years about 80%, at 15 years about 55%, and at 20 years about 40%. Mount Si­nai Heart features the daVinci Sur­gi­cal Sys­tem, a robotic de­vice sur­geons use to per­form min­i­mally in­va­sive by­pass surgery. The tech­nol­ogy makes use of fin­ger­tip-size in­ci­sions, al­low­ing pa­tients a shorter hospi­tal stay and a speed­ier re­cov­ery. An­other tech­nique is the off-pump by­pass, or "beat­ing heart" surgery. Sur­geons of­ten per­form by­pass surgery us­ing a heart-lung ma­chine, which stops the heart from beat­ing, al­low­ing sur­geons to op­er­ate on a mo­tion­less, blood-free sur­face. The ma­chine draws blood out of the heart and sends it to an ar­ti­fi­cial lung out­side the body, where it re­ceives oxy­gen. The newly oxy­genated blood is then sent back into the blood­stream through the aorta, where it cir­cu­lates through­out the rest of the body.

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