Cardiac Services

Cardiothoracic Surgery

Coronary Bypass Surgery

Heart bypass surgery creates a detour or "bypass" around the blocked part of a coronary artery to restore the blood supply to the heart muscle. The surgery is commonly called Coronary Artery Bypass Graft.

Although the advent of less invasive angioplasty and stent procedures has resulted in decreased numbers of coronary bypass procedures, surgical intervention for coronary artery disease continues to be a major component of treatment at The Miriam Hospital.

The coordinated efforts of the interventional cardiologists and surgeons/ have resulted in the treatment of a significantly larger group of patients, particularly those with multiple risk factors, advanced age and severely diseased blood vessels. Cleaning plaque from the arteries (endartarectomy) has become a common procedure with excellent results.

The internal mammary artery is used as a bypass vessel in 98 percent of patients. This artery, located inside the chest wall is known for its extended patency and function and is associated with improved longterm survival. Vessels used for bypass have long been limited to leg veins (saphenous veins), resulting in long and often painful leg scars. Today, arteries taken from the arm are used (nearly 70 percent of cases) because arteries appear to last longer than veins. Nearly all of the vessels are taken by minimally invasive endoscopic (camera) techniques resulting in less painful incisions and more cosmetically pleasing results.

The heart-lung machine is no longer used in every patient undergoing coronary bypass surgery. The surgical team now performs about 20 percent of cases “off pump” (OPCAB) resulting in shorter postoperative stays. This approach is particularly helpful for patients with advanced lung or kidney disease, as well as certain bleeding disorders.

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