Heart Bypass Surgery
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.