Heart Bypass Surgery

Heart Bypass Surgery is a highly complex but routine procedure that was first developed back in the late 1950's and early 1960's. In principal, it hasn't changed much since then, but as you'd expect, technologically there has of course been significant progress and skill development in that time.

Heart surgery...which has often commonly been referred to as open heart surgery is usually aimed at treating either the coronary artery disease process, known as Atherosclerosis, diseased heart valves or congenital heart abnormalities by surgical means.

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Grafting a new pathway or conduit to a coronary artery beyond a narrow, blocked or diseased portion of the vessel, replacing a diseased heart valve or repairing a 'hole in the heart' are common examples of heart bypass operation.

With the heart stopped, and in order for the patient to survive the procedure, freshly oxygenated blood still needs to be circulated around the body. This requires the use of a mechanical device sometimes called a heart-lung machine, pump-oxygenator or cardiopulmonary bypass machine.

You may be surprised to learn that experimentation to improve the blood supply to the heart muscle where the patient had obvious symptoms of coronary artery disease began as far back as the 1940's with the Vineberg operation.

Then, in the late 1950's a surgical procedure called Internal Mammary Artery Ligation was introduced as a way of treating the symptoms (angina) of coronary heart disease.

Both these procedures were early attempts to 're-plumb' the heart muscle with a stable blood supply and to a degree were for-runners of today's sophisticated heart bypass procedures. However, while these two procedures were both surgical operations, they were not heart bypass operations, as the use of a heart-lung machine was not employed.

coronary artery bypass graft surgery or CABG is a specific type of heart surgery where an adequate supply of freshly oxygenated blood is ideally restored to the heart muscle that has previously been 'rationed' as a result of coronary artery disease being present in portions of the coronary arteries. This rationing of blood supply to the heart muscle is called ischemia and the patient experiences this as angina (chest pain) and shortness of breath with exertion.

Although coronary bypass surgery has become a surgical gold standard for treating the symptoms of coronary heart disease and helping to provide a functional blood supply to the heart muscle, new innovations have been developed in recent years that provide both the surgeon and the patient with an alternative approach to traditional heart bypass surgery which has always necessitated the use of cardiopulmonary bypass machine and cardioplegia to stop the heart.

These newer surgical innovations include:

  • Off Pump Heart Surgery where Beating Heart Bypass procedures are employed and the use of devices such as the octopus heart stabilizer may be used.

  • Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)

  • Totally Endoscopic Coronary Artery Bypass Surgery (TECAB)
  • How common is it for coronary bypass procedures to be performed?

    According to the American Heart Association's Heart Disease and Stroke Statistics – 2009 Update, 448,000 cardiac revascularization procedures (another name for coronary artery bypass graft or CABG procedures) were performed in the United States alone during 2006.

    On top of that, well over one million coronary angioplasties (percutaneous coronary interventions or PCIs) where a balloon and stent are utilized to treat blockages and narrowings in the coronary arteries were also carried out during that year.

    Clearly, the keeping healthy lifestyle modification message...one where significant changes are made to ones lifestyle to help prevent disease and the breaking down of the false idea that heart disease is an inevitability has some considerable way to go before heart bypass surgery becomes a rarity.

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