Coronary Artery Disease Surgery
Surgical Treatment Options
Your doctor may recommend a surgical procedure to treat severe CAD, ease your symptoms and reduce your risk of a heart attack. Both angioplasty and bypass surgery are used as treatments.
Angioplasty – Angioplasty opens blocked or narrowed coronary arteries. During surgery, a thin tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery. This widens the artery and restores the flow of blood. Angioplasty can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure.
Bypass surgery – This type of surgery is often referred to as CABG (coronary artery bypass graft surgery) and is also known as coronary revascularization. The goal is to improve blood flow to your heart, relieve chest pain and possibly prevent a heart attack. In traditional bypass, surgeons access the heart by making an 8- to 10-inch incision down the chest, cutting through the breastbone (the sternum) and opening the ribs. This is known as a sternotomy. Surgeons then take a segment of a healthy, plaque-free blood vessel from another part of your body (chest, leg or arm) and attach one end of that vessel to a healthy artery and the other end to the diseased coronary artery below the clogged area. This creates a new channel, allowing blood to flow freely to your heart again.
A pump oxygenator (heart-lung machine) is used for most coronary bypass operations. It takes over the function of the heart and lungs during surgery. Recently, more surgeons are performing off-pump coronary artery bypass surgery, where the heart continues beating while the bypass graft is sewn in place. In many patients, an off-pump approach may reduce serious complications during or after surgery.
Following surgery, patients usually stay in the hospital four to six days. Patients are often enrolled in a cardiac rehabilitation program to learn about stress management, diet and exercise.
da Vinci Surgery for CAD
If you have been told you need bypass surgery, ask your doctor about da Vinci Surgery for coronary artery disease. This procedure is performed without the need for a heart-lung machine, minimally invasively through small incisions made between the ribs. This avoids the need for a sternotomy, its associated risks and complications. da Vinci Coronary Revascularization can also offer several potential benefits over open heart surgery, including:
- Shorter hospital stay 3
- Less pain and scarring 2
- Less risk of infection2
- Less blood loss and need for blood transfusions 3
- Faster recovery2
- Quicker return to normal activities2
da Vinci Surgery is a breakthrough surgical system that enables surgeons to operate with unmatched precision, 3D-high definition vision and superior control. By overcoming the limitations of traditional open surgery, da Vinci is revolutionizing cardiothoracic surgery.
As with any surgery, these benefits cannot be guaranteed, as surgery is patient-and procedure specific.
2. “How is Coronary Artery Disease Treated?” National Institutes of Health, www.nhibi.nih.gov , URL: http://www.nhlbi.nih.gov/health/dci/Diseases/Cad/CAD_Treatments.html
3. Poston RS, Tran R, Collins M, Reynolds M, Connerney I, Reicher B, Zimrin D, Griffith BP, Bartlett ST. Comparison of economic and patient outcomes with minimally invasive versus traditional off-pump coronary artery bypass grafting techniques. Ann Surg. 2008 Oct;248(4):638-46.
While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.