Coronary artery bypass grafting is performed when arteries that supply oxygen to the heart become blocked or narrowed, typically from coronary artery disease (CAD).
What is Coronary Artery Disease?
CAD is a narrowing or blockage of the coronary arteries in your heart, usually caused by the buildup of fatty, cholesterol-containing deposits called plaque. This buildup can cause the arteries to become narrow, and less blood is able to flow through them. This narrowing can lead to chest pain, shortness of breath, and other symptoms. It could also lead to a heart attack.
What is Coronary Artery Bypass Grafting?
To restore blood flow to the coronary arteries, some patients are referred for coronary artery bypass grafting (also referred to as a coronary artery bypass surgery, or CABG).
In this procedure, a surgeon uses a blood vessel from another part of your body to route blood around, or “bypass,” the narrowing or blockage in your coronary artery. The vessel, known as a bypass graft, helps to restore normal blood flow through your coronary arteries to support your heart.
What to Expect with Bypass Surgery
If it is determined that you need bypass surgery, you will have a number of tests and appointments before the procedure including blood tests, X-rays, electrocardiograms (EKGs), CT scans, and more.
You will meet with a nurse practitioner and your cardiothoracic surgeon, who will provide information about the surgery and your recovery.
Your surgical team, including your cardiothoracic surgeon and anesthesiologist, will work with your cardiologist and any other specialist you see to ensure you receive the best possible care before, during and after surgery.
On the day of surgery, most patients arrive several hours before the start of surgery. The surgery itself lasts for about 4-5 hours.
After surgery, you will recover in the Cardiac Surgical Intensive Care Unit (CSICU), where cardiac specialists will monitor your care. Patients typically remain in the CSICU for about 24 hours before they move to a private room on a monitored inpatient unit.
A nursing case manager will be involved in helping plan your safe transition at the time of discharge, with most patients returning home about five days after surgery.
Once you are home, home care nursing services will be arranged, and someone will visit you in within 48 hours of discharge. You will be encouraged to walk and use the stairs if needed, but lifting (above 5-7 pounds) and driving a car are not allowed initially. The team at Valley will be available to answer any questions that you or your family might have during your first few days and weeks at home.
One week after you are discharged from the hospital, you will have a follow-up with your cardiologist. Your follow-up with your surgeon will be between two and six weeks after surgery. Your doctors will let you know when you can resume activities such as driving or lifting. Patients who have heart surgery at Valley are also referred for cardiac rehabilitation, to ensure they are on the road to recovery.
Why Choose Valley for Coronary Artery Bypass Surgery?
Philosophy of Personalized Care
The cardiothoracic surgeons at Valley do not believe in a “one-size-fits-all” approach to coronary artery bypass surgery grafting. Each procedure is planned specifically for the individual patient, thinking about the anatomy of their heart, other health conditions they might have, and a number of other factors.
We strive to create an environment where each and every patient feels safe, supported, and cared for, starting with their very first interaction with our team.
Ensuring that the patient understands their diagnosis and treatment options, we help to empower our patients and their families to make choices that work for them. We encourage patients and family members to reach out to the dedicated nurse practitioners at any time, who are always available to address concerns and questions.
The cardiothoracic surgeons at Valley have expertise in specialized surgical techniques and approaches including:
Endoscopic Vessel Harvesting
Your cardiothoracic surgeon may need to use a vessel from your leg or forearm to bypass the blockages in your heart. This advanced technique is called endoscopic vessel harvesting. While traditional techniques result in very long incisions to harvest the vessel, the endoscopic vessel harvesting approach uses just two small incisions. This in turn reduces pain, the risk of infections, and helps you start healing.
Off-Pump Coronary Artery Bypass Surgery (Beating Heart Surgery)
In traditional bypass surgery (on-pump surgery), the heart is stopped, and surgeons use a heart-lung machine to stabilize the patient. With beating heart surgery, we don’t stop the heart or use a heart-lung machine. At Valley, many patients have the option of an off-pump or beating heart bypass surgery, with benefits that include: a shorter hospital stay and recovery, reduced bleeding, reduced chance of infection, and reduced risk of an irregular heartbeat.
Minimally Invasive Approaches
The cardiothoracic surgeons at Valley are experienced with less invasive approaches to coronary artery bypass grafting, including minimally invasive direct coronary artery bypass (MIDCAB), minimally invasive coronary artery bypass grafting, and the use of mini-sternotomy. Our cardiothoracic surgeons will explain whether a less invasive approach might be appropriate for your surgery.
Advanced Multi-Arterial Grafting
Patients undergoing coronary artery bypass grafting have better long-term outcomes if their surgery is performed using mostly or all arterial bypass grafts. The cardiothoracic surgeons at Valley use a variety of approaches and techniques to provide patients with multi- or all-arterial grafting. These can include the use of sequential grafts, where a single vessel is used to bypass several blockages. It could also include the use of a Y or T graft, which helps reach more remote blockages.
Repeat Coronary Artery Bypass Grafting, and Grafting of Stenosed or Occluded Stents
Some patients who have previously had their coronary artery disease treated with either stents or bypass surgery may experience new onset symptoms. The cardiothoracic surgeons at Valley hospital are experienced in approaching high-risk repeat coronary artery bypass grafting or grafting occluded stents. Our team can relieve symptoms and provide durable, long-term outcomes for patients.
Your cardiothoracic surgeon will develop an individual plan for your coronary artery bypass grafting that considers your symptoms, the location of the blockages in your heart, and other factors that are specific to you.
For more information on coronary artery bypass surgery or to schedule an appointment, please call 201-447-8377.