Our Summary

This research paper examines the long-term results of a less invasive heart bypass surgery, specifically for the left thoracic artery on the left anterior descending artery. This type of surgery was performed on 1,060 patients between 1997 and 2016. Some of these patients only had blockages in the proximal left anterior descending artery, while others had blockages in multiple vessels.

The average age of these patients was 71 years old. After surgery, only 0.8% of these patients died and 0.3% experienced a stroke. A scan was performed on some patients up to 10 years after their surgery. These scans showed that for 96.8% of these patients, the graft (the piece of blood vessel used to bypass the blocked artery) was still working well.

After an average follow-up period of almost 14 years, none of these patients needed another surgery because the graft failed. However, 14 patients did need a procedure to open up either the left anterior descending artery or the graft. Survival rates were 87.1% after 5 years, 84.3% after 10 years, and 79.8% after 15 years. The likelihood of patients surviving without major health issues was 87.0% after 5 years and 70.5% after 15 years.

In conclusion, this less invasive heart bypass surgery has low risks of death and illness after the operation. It also has high survival rates and most patients don’t experience major health issues or chest pain. These results are promising, especially considering the less invasive nature of the surgery.

FAQs

  1. What is the survival rate for patients who undergo this less invasive heart bypass surgery?
  2. How effective is the graft used in the less invasive heart bypass surgery in the long term?
  3. How many patients needed additional procedures after the less invasive heart bypass surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about coronary artery bypass surgery is to follow a healthy lifestyle after the procedure. This includes maintaining a balanced diet, engaging in regular physical activity, quitting smoking, managing stress, and taking prescribed medications as directed. These lifestyle changes can help improve the long-term success and outcomes of the bypass surgery. Additionally, regular follow-up appointments with your healthcare team are important for monitoring your heart health and addressing any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for coronary artery bypass surgery are those with severe blockages in their coronary arteries that cannot be effectively treated with medications or less invasive procedures such as angioplasty. Patients with significant narrowing or blockages in multiple coronary arteries, including the left anterior descending artery, may benefit from coronary artery bypass surgery.

In the study mentioned above, patients with blockages in the left anterior descending artery who underwent less invasive heart bypass surgery had favorable long-term outcomes. The surgery was particularly successful in patients with blockages only in the proximal left anterior descending artery. Older patients, such as those in their 70s, may also be candidates for coronary artery bypass surgery, as demonstrated by the average age of patients in the study.

Overall, patients who are at high risk of heart attack, heart failure, or other complications due to severe coronary artery disease may be recommended for coronary artery bypass surgery. It is important for patients to discuss their individual risk factors and treatment options with their healthcare provider to determine the most appropriate course of action for their specific condition.

Timeline

Before the coronary artery bypass surgery:

  1. Patient undergoes diagnostic tests such as angiography to determine the extent of blockage in the arteries.
  2. Patient may be prescribed medications to manage symptoms and reduce the risk of complications.
  3. Patient undergoes pre-operative assessments and consultations with the surgical team.
  4. Patient may need to make lifestyle changes such as quitting smoking, improving diet, and increasing physical activity.

After the coronary artery bypass surgery:

  1. Patient is monitored closely in the intensive care unit immediately after surgery.
  2. Patient will stay in the hospital for a few days to recover and receive post-operative care.
  3. Patient will be prescribed medications to manage pain, prevent infection, and reduce the risk of blood clots.
  4. Patient will undergo cardiac rehabilitation to improve physical strength and overall cardiovascular health.
  5. Patient will have follow-up appointments with the surgical team to monitor recovery and assess the long-term success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about coronary artery bypass surgery include:

  1. What are the risks and potential complications associated with this surgery?
  2. How long is the recovery process and what can I expect during this time?
  3. Will I need to make any lifestyle changes or take medications after the surgery?
  4. How long will the bypass graft last and what is the likelihood of needing another procedure in the future?
  5. What are the success rates of this specific type of bypass surgery, particularly in the long-term?
  6. What is the expected outcome in terms of symptom relief and improvement in quality of life?
  7. Are there any alternative treatment options that I should consider?
  8. How many of these procedures have you performed and what is your experience with this specific type of surgery?
  9. Can you provide me with information about the hospital where the surgery will be performed and its success rates for this procedure?
  10. Are there any additional tests or evaluations that need to be done before scheduling the surgery?

Reference

Authors: Repossini A, Di Bacco L, Nicoli F, Passaretti B, Stara A, Jonida B, Muneretto C. Journal: J Thorac Cardiovasc Surg. 2019 Jul;158(1):127-138.e1. doi: 10.1016/j.jtcvs.2018.11.149. Epub 2018 Dec 29. PMID: 30739774