Our Summary
This study looked at the process and outcomes of the first 100 cases of a type of heart surgery called minimally invasive cardiac surgery (MICS) coronary artery bypass grafting (CABG) at a particular medical center. The researchers studied the duration of the surgeries and the outcomes of the patients to understand how quickly the surgical team became proficient at the procedure (their “learning curve”).
The average age of the patients was approximately 59 years, with more males than females. All patients underwent the same type of surgery, involving making a small incision on the left side of the chest. The surgery involved taking a blood vessel from another part of the body and using it to bypass a blocked artery in the heart. On average, the surgery took about 132 minutes and patients stayed in the intensive care unit for about 2.5 days.
The researchers found a significant reduction in the duration of the surgery after the first 20 cases, indicating that the surgical team had become more efficient at the procedure. The study concluded that this type of heart surgery can be performed with a similar level of comfort for cases involving multiple blocked arteries as for cases involving single or double blocked arteries. The researchers also found that compared to another type of heart surgery (sternotomy), patients who had MICS CABG had shorter ventilation times, less post-operative pain, shorter stays in the ICU and hospital, with no difference in post-operative complications.
FAQs
- What is minimally invasive cardiac surgery (MICS) coronary artery bypass grafting (CABG)?
- What were the findings of the study regarding MICS CABG efficiency and patient outcomes?
- How does MICS CABG compare to sternotomy in terms of patient recovery and post-operative complications?
Doctor’s Tip
A doctor might tell a patient about CABG that it is a minimally invasive procedure that involves bypassing blocked arteries in the heart using a blood vessel from another part of the body. Patients undergoing this surgery can expect shorter ventilation times, less post-operative pain, and shorter stays in the ICU and hospital compared to traditional heart surgery. The surgical team typically becomes more proficient at the procedure after the first 20 cases, leading to more efficient surgeries and better outcomes for patients.
Suitable For
Patients who are typically recommended for CABG include those with significant blockages in the coronary arteries that cannot be managed with medication or less invasive procedures such as angioplasty. These blockages can lead to symptoms such as chest pain (angina) or shortness of breath, or can increase the risk of a heart attack. Patients with multiple blockages or blockages in critical arteries may be good candidates for CABG.
In the study mentioned above, the patients who underwent MICS CABG were found to have similar outcomes to those who underwent sternotomy, but with certain advantages such as shorter recovery times and less post-operative pain. Therefore, patients who are looking for a less invasive approach to CABG may be good candidates for MICS CABG.
Overall, the decision to recommend CABG for a patient will depend on factors such as the extent and location of the blockages, the patient’s overall health and medical history, and the risks and benefits of the procedure. It is important for patients to discuss their options with their healthcare provider to determine the best course of treatment for their individual situation.
Timeline
Before CABG surgery: The patient will undergo various tests and evaluations to determine the severity of their heart condition and whether they are a suitable candidate for surgery. This may include imaging tests, blood tests, and a physical examination. The patient may also need to make lifestyle changes or take medications to manage their condition leading up to surgery.
Day of surgery: The patient will be admitted to the hospital and prepared for surgery. They will meet with the surgical team, anesthesiologist, and other medical staff to go over the procedure and address any concerns. The patient will be given anesthesia before the surgery begins.
During CABG surgery: The surgeon will make an incision in the chest to access the heart. The blocked arteries will be bypassed using healthy blood vessels taken from elsewhere in the body. The surgery may take several hours to complete, depending on the number of blockages and complexity of the procedure.
After CABG surgery: The patient will be monitored closely in the intensive care unit (ICU) for a few days to ensure they are stable and recovering well. They may be on a ventilator to help with breathing and will receive pain medication as needed. The patient will gradually transition to a regular hospital room and begin physical therapy to regain strength and mobility.
Recovery at home: The patient will be discharged from the hospital once they are stable and able to manage at home. They will need to follow a strict medication regimen, attend follow-up appointments with their healthcare team, and participate in cardiac rehabilitation to improve their heart health. It may take several weeks to months for the patient to fully recover and resume normal activities.
What to Ask Your Doctor
- How many surgeries of this type have you performed?
- What is your success rate with this procedure?
- What are the potential risks and complications associated with this surgery?
- How long is the recovery process expected to take?
- Will I need to make any lifestyle changes after the surgery?
- What kind of follow-up care will be required after the surgery?
- Are there any alternative treatment options to consider?
- What can I expect in terms of pain management during and after the surgery?
- How soon after the surgery can I return to normal activities?
- Are there any specific dietary restrictions I need to follow post-surgery?
Reference
Authors: Rajput NK, Kalangi TKV, Andappan A, Swain AK. Journal: Indian J Thorac Cardiovasc Surg. 2021 Jan;37(1):16-26. doi: 10.1007/s12055-020-01048-2. Epub 2020 Oct 7. PMID: 33442204