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Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart.
Minimally invasive coronary (heart) artery bypass can be done without stopping the heart. Therefore, you do not need to be put on a heart-lung machine for this procedure.
Minimally invasive direct coronary artery bypass; MIDCAB; Robot assisted coronary artery bypass; RACAB; Keyhole heart surgery
To perform this surgery:
You will not be on a heart-lung machine for this surgery. A device will be attached to your heart to stabilize it. You will also receive medicine to slow the heart down.
Your doctor may recommend a minimally invasive coronary artery bypass if you have a blockage in one or two coronary arteries, usually in the front of the heart. When one or more of the coronary arteries become partly or totally blocked, your heart does not get enough blood. This is called ischemic heart disease or coronary artery disease. It can cause chest pain (angina).
Your doctor may have first tried to treat you with medicines. You may have also tried cardiac rehabilitation or other treatments, such as angioplasty with stenting.
Coronary artery disease varies from person to person. Heart bypass surgery is just one type of treatment. It is not right for everyone.
Surgeries or procedures that may be done instead of minimally invasive heart bypass are:
Your doctor will talk to you about the risks of surgery. In general, the complications of minimally invasive coronary artery bypass are lower than with open coronary artery bypass surgery.
Risks for any surgery include:
Possible risks of coronary artery bypass include:
Always tell your doctor or nurse what drugs you are taking, even drugs or herbs you bought without a prescription.
During the days before the surgery:
The day before your surgery:
On the day of the surgery:
Your doctor or nurse will tell you when to arrive at the hospital.
You may be able to leave the hospital 2 or 3 days after your surgery. The nurse will tell you how to care for yourself at home. You may be able to return to normal activities after 2 or 3 weeks.
Recovery from surgery takes time, and you may not see the full benefits of your surgery for 3 to 6 months. In most people who have heart bypass surgery, the grafts remain open and work well for many years.
This surgery does not prevent a blockage from coming back. However, you can take steps to slow it down. Things you can do include:
You may be more likely to have problems with your blood vessels if you have kidney disease or other medical problems.
Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124: e652-e735.
Gopaldas RR, Chu, D, Bakaeen FG, et al. Acquired Heart Disease: Coronary Insufficiency. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 60.
Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007;116(23):2762-2772.
Møller CH, Perko MJ, Lund JT, et al. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial. Circulation. 2010 Feb 2;121(4):498-504. Epub 2010 Jan 18.
Thiele H, Neumann-Schniedewind P, Jacobs S, et al. Randomized comparison of minimally invasive direct coronary artery bypass surgery versus sirolimus-eluting stenting in isolated proximal left anterior descending coronary artery stenosis. J Am Coll Cardiol. 2009 Jun 23;53(25):2324-31.
Reviewed By: Norman S. Kato, MD, Surgeon with the Cardiac Care Medical Group, Encino, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.