Our Summary
This research paper reviews the progress made in less invasive techniques for bypass surgery on multiple coronary arteries. These techniques have improved over the last twenty years and can now be used in most patients who need this type of surgery. The paper highlights the importance of these techniques as part of a range of treatment options, and presents evidence supporting their use.
The authors discuss a large-scale study in two medical centers that showed it was possible to use minimally invasive techniques for bypass surgery on multiple coronary arteries. This process doesn’t require cutting through the breastbone or using a heart-lung machine. Follow-up studies showed very good early results. When compared to traditional bypass surgery, the minimally invasive method led to faster recovery times, shorter hospital stays, and lower costs.
The paper discusses two specific types of less invasive bypass surgery - MICS CABG and TECAB. MICS CABG has proven to be as safe and effective as traditional bypass surgery, but without the associated risks. It can be easily reproduced and used in a variety of situations, making it a promising choice for future surgeries. TECAB is considered the most advanced form of minimally invasive coronary surgery, but its growth is hindered by a lack of widespread acceptance and industry involvement.
FAQs
- What are the benefits of minimally invasive coronary artery bypass grafting (MICS CABG) compared to conventional CABG?
- What is the difference between MICS CABG and robotically assisted totally endoscopic CABG (TECAB)?
- What recent findings have been made about the efficacy and safety of MICS CABG?
Doctor’s Tip
A helpful tip a doctor might tell a patient about heart bypass is to follow a healthy lifestyle after the procedure to help maintain the benefits of the surgery. This includes regular exercise, a balanced diet, managing stress, quitting smoking, and taking prescribed medications as directed. Regular follow-up appointments with your healthcare team are also important to monitor your heart health and make any necessary adjustments to your treatment plan.
Suitable For
Patients who are typically recommended for heart bypass surgery include those with severe coronary artery disease that cannot be effectively treated with medications or less invasive procedures such as angioplasty and stenting. Specifically, patients with multivessel disease, where multiple coronary arteries are blocked or narrowed, may benefit from heart bypass surgery. Additionally, patients with left main coronary artery disease, which is a blockage in a major artery supplying a large portion of the heart, may also be recommended for bypass surgery.
Patients with symptoms of angina (chest pain or discomfort) that are not relieved with medication or lifestyle changes may also be candidates for heart bypass surgery. Other factors that may indicate the need for bypass surgery include a history of heart attacks, heart failure, or other complications of coronary artery disease.
Ultimately, the decision to recommend heart bypass surgery is made on a case-by-case basis by a cardiac surgeon and a multidisciplinary team of healthcare providers, taking into consideration the patient’s overall health, the extent and severity of their coronary artery disease, and their individual risk factors.
Timeline
Before heart bypass surgery, a patient typically undergoes a series of tests and evaluations to determine the extent of their coronary artery disease and the best course of treatment. This may include a coronary angiogram, stress tests, and other imaging studies. The patient may also need to make lifestyle changes and possibly start medications to manage their condition.
After heart bypass surgery, the patient will typically spend several days in the hospital recovering. They will be monitored closely for any complications and will receive pain management as needed. Once discharged, the patient will need to follow a strict regimen of medications, lifestyle changes, and cardiac rehabilitation to aid in their recovery and prevent further heart issues. Follow-up appointments with their healthcare provider will be scheduled to monitor their progress and make any necessary adjustments to their treatment plan.
What to Ask Your Doctor
Some questions a patient should ask their doctor about heart bypass surgery include:
- What are the benefits of minimally invasive multivessel coronary artery bypass grafting techniques compared to traditional open-heart surgery?
- Am I a candidate for minimally invasive heart bypass surgery?
- What are the potential risks and complications associated with minimally invasive heart bypass surgery?
- How long is the recovery time for minimally invasive heart bypass surgery compared to traditional open-heart surgery?
- Will I need to undergo cardiopulmonary bypass during minimally invasive heart bypass surgery?
- How long do the grafts typically last in minimally invasive heart bypass surgery?
- What is the success rate of minimally invasive heart bypass surgery compared to traditional open-heart surgery?
- Are there any long-term considerations or lifestyle changes I should be aware of after undergoing minimally invasive heart bypass surgery?
- How experienced is the surgical team in performing minimally invasive heart bypass surgery?
- Are there any alternative treatments or procedures that I should consider before deciding on heart bypass surgery?
Reference
Authors: Nambala S, Mishra YK, Ruel M. Journal: Curr Opin Cardiol. 2021 Nov 1;36(6):735-739. doi: 10.1097/HCO.0000000000000906. PMID: 34456253