According the American Heart Association, heart bypass surgery or coronary bypass surgery treats blocked heart arteries. In this procedure doctors create a new passage for blood flow to a patient's heart. Veins of arteries from other parts of the patient's body such as legs, or arms can be used to reroute the blood around the blocked artery. Coronary bypass surgery reduces the risk of heart attack, relieves chest pain and improves the supply of oxygen and blood to the heart. This procedure is one of the most commonly performed surgeries in the United States. Several different variations of this surgery exist.
Traditional Heart Bypass Surgery
The traditional bypass surgery lasts about four to five hours. In this surgery, a doctor makes a six to eight inch incision down the center of patient's breastbone to access the heart. During this open-chest surgery, the patient is connected to a heart-lung bypass machine. This is why the procedure is sometimes called "on-pump" surgery. The heart-lung bypass machine circulates the blood throughout the patient's body during the surgery. Surgeon takes veins of arteries from chest, legs or arms and uses them to reroute the blood around the blocked artery. It is possible to bypass up to four blocked coronary arteries during one bypass surgery.
Off-Pump Heart Bypass Surgery
Instead of performing a traditional open heart surgery, a surgeon may opt for a newer, less invasive technique such as off-pump bypass surgery. In this procedure, the heart is not stopped but only slowed down with medicine, says the Medic8.com. During the operation, the doctor stabilizes a portion of the heart while the rest of the heart keeps pumping. Because of this, the heart-lung bypass machine is not needed. Otherwise, the off-pump method resembles the traditional bypass surgery and requires the same large incision. The off-pump method is an idea for patients with vascular disease, prior stroke, kidney problems, or blockage in the arteries that lead to the brain. These patients might have an increased risk of complications, such as irregular heart rhythm, if they were placed on the heart-lung machine. Dr. Jakub J. Regieli and colleagues showed in a study presented at the "American Heart Association's Scientific Sessions" in November 2009 that patients who had the off-pump procedure had better long-term cognitive performance that those, who had traditional bypass surgery.
Minimally Invasive Heart Bypass Surgery
Just like in the off-pump bypass surgery, the heart-lung bypass machine is not needed in a minimally invasive bypass surgery. In this method, the surgeon will cut several small incisions in the chest instead of one large incision to access the coronary arteries. These smaller incisions expose only the sections of the arteries that require bypass. Surgeon may also use robotic-assisted techniques that allow them to perform bypass surgery through even smaller keyhole incisions. The advantages of minimally invasive bypass surgery include a smaller scar, shorter recovery time, less bleeding, less pain and reduced infection risk. This is also an ideal method for people who have received radiation for their chest. The main disadvantage of minimally invasive bypass surgery is that it cannot be used to treat more than two coronary arteries during the same surgery.
