Our Summary

This research paper looked at patients with a high risk of death - according to a scoring system used by the Society of Thoracic Surgeons (STS) - who were undergoing a particular type of heart surgery. The procedure, called ‘robotic totally endoscopic beating heart coronary artery bypass surgery’, is used to improve blood flow to the heart.

The researchers compared 50 high-risk patients to 220 lower-risk patients who had the same surgery between 2013 and 2017. They found that the high-risk group had a higher rate of kidney problems, peripheral vascular disease, and lower heart function. However, the risk of complications after surgery, such as bleeding, stroke, heart attack, and need for prolonged ventilation, was similar for both groups.

Interestingly, the high-risk group had a lower death rate than the lower-risk group. They did, however, need more blood transfusions and had to stay in the hospital longer. The researchers concluded that this type of heart surgery can be safely done in high-risk patients, but further studies are needed to see how these patients do in the long term.

FAQs

  1. What is ‘robotic totally endoscopic beating heart coronary artery bypass surgery’?
  2. What were the main findings of the research regarding high-risk and low-risk patients undergoing this surgery?
  3. Are there plans for further studies on the long term effects of this surgery on high-risk patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about heart bypass surgery is to follow a healthy lifestyle after surgery to improve the long-term success of the procedure. This includes maintaining a balanced diet, staying physically active, quitting smoking, managing stress, and taking medications as prescribed. It is important to attend follow-up appointments and communicate any concerns or symptoms to your healthcare team. By taking these steps, patients can optimize their recovery and reduce the risk of future heart problems.

Suitable For

Typically, patients who are recommended for heart bypass surgery are those with severe coronary artery disease, which is a condition where the blood vessels that supply the heart with oxygen-rich blood become narrowed or blocked. This can lead to chest pain (angina), shortness of breath, and in severe cases, heart attacks.

Patients who may be recommended for heart bypass surgery include those with:

  • Severe blockages in multiple coronary arteries
  • Poor heart function
  • Diabetic patients with multiple blockages
  • Patients with previous heart procedures that have failed
  • Patients who are at a high risk for complications during surgery, such as older adults or those with other medical conditions

Overall, the decision to recommend heart bypass surgery is based on a combination of factors, including the severity of the coronary artery disease, the patient’s overall health and risk factors, and the potential benefits of the surgery in improving blood flow to the heart. 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 heart bypass surgery, a patient may experience symptoms such as chest pain, shortness of breath, fatigue, and other signs of heart disease. They will undergo various tests and evaluations to determine the severity of their condition and whether they are a candidate for surgery.

During the surgery, the patient is placed under general anesthesia and the surgeon will create new pathways for blood to flow to the heart by using blood vessels from other parts of the body. The surgery can take several hours to complete.

After the surgery, the patient will be closely monitored in the intensive care unit (ICU) for a period of time before being transferred to a regular hospital room. They will need to stay in the hospital for several days to recover and receive physical therapy to regain strength.

In the weeks and months following the surgery, the patient will need to follow a strict medication regimen, attend cardiac rehabilitation, and make lifestyle changes to improve their overall heart health. Regular follow-up appointments with their healthcare team will be necessary to monitor their progress and make any necessary adjustments to their treatment plan.

What to Ask Your Doctor

  1. What specific factors make me a high-risk candidate for heart bypass surgery?
  2. How does the robotic totally endoscopic beating heart coronary artery bypass surgery differ from traditional bypass surgery?
  3. What are the potential complications and risks associated with this type of surgery?
  4. How long can I expect to be in the hospital after the surgery?
  5. What is the recovery process like for high-risk patients compared to lower-risk patients?
  6. Will I need any additional follow-up care or monitoring after the surgery?
  7. How does my current heart function and overall health impact the success of the surgery?
  8. What lifestyle changes or medications will I need to incorporate into my daily routine post-surgery?
  9. Are there any specific warning signs or symptoms I should watch out for after the surgery?
  10. Are there any alternative treatment options or additional procedures that may be beneficial for my specific condition?

Reference

Authors: Balkhy HH, Nisivaco S, Kitahara H, McCrorey M, Patel B. Journal: Innovations (Phila). 2018 Mar/Apr;13(2):108-113. doi: 10.1097/IMI.0000000000000481. PMID: 29688940