Heart bypass surgery is sometimes referred to as a coronary artery bypass grafting, CABG, in medical terminology. This means that the coronary arteries have blockages significant enough deplete the heart muscle of oxygen and cause chest pain. The patient may even have had a heart attack. This surgery bypasses the blocked arteries and provides a new conduit for blood flow into the heart. Heart surgery is major surgery and requires a specialized surgeon. There are several approaches to performing heart bypass.
On Bypass
The on bypass procedure requires the surgeon to make an incision from the sternal notch, the very top of the chest where the sternum begins, all the way down to the xiphoid, where the sternum ends. The sternum is then opened with a medical jigsaw and a retractor is placed so that the entire heart is exposed. This is called a sternotomy. Once the heart is exposed, the surgeon places the patient on the heart/lung bypass machine to bypass the circulation of the heart. The heart/lung machine perfuses the body while the heart is not pumping. Conduit is then harvested from the leg or arm and the bypass to the coronary arteries is done by visualizing the entire heart. This is the traditional way of performing bypass surgery.
Off Bypass
Off bypass means that the surgery is done without the heart/lung machine. The surgeon opens the chest in the traditional way but performs the surgery on a beating heart. Not using the heart/lung machine means tubes do not need to be placed in the aorta, where occasionally calcifications can be broken off and shed to the brain, causing stroke. Patients who are good candidates for this surgery have strong hearts and are otherwise healthy, according to the Women's Heart Foundation.
Robotics
By using tiny, precise incisions, surgeons can access the heart without performing a sternotomy. Minimally invasive heart surgery allows for faster recovery times and shorter hospital stays. Thin instruments, miniature cameras and robotics assist the surgeon in the performance of these surgeries, according to the Chicago Medical Center. The robot allows the surgeon to perform the surgery with a greater degree of control and precision. Only those surgeons with specialized training should perform these types of procedures.
