Coronary Artery Bypass Surgery
If you have been diagnosed with coronary artery disease, you and your medical team may be considering coronary artery bypass surgery. During this stressful time, keep in mind that coronary bypass surgery is extremely safe and effective and is becoming even more so.

Coronary artery bypass surgery is typically done in patients with:

• A blocked left main coronary artery
• Disease in several vessels (multi-vessel disease)
• Poor left ventricular function
• Debilitating chest pain

Until recently, all coronary bypass operations were performed by surgeons who stopped the heart and used a heart-lung machine to support the body's circulation and allow surgeons to operate on a surface which is blood-free and still. The heart-lung machine removes carbon dioxide from the blood and replaces it with oxygen before pumping it around the body. The heart-lung machine has, and continues to save, countless lives.

Today, off-pump coronary artery bypass grafts (CABG) are an option for many patients. Physicians affiliated with the Regional Heart Institute performed the first off-pump procedure in Rockford at OSF Saint Anthony Medical Center in the 1990s.

Off-pump procedures let patients undergo surgery without the heart-lung machine. This is a minimally invasive technique that lets surgeons operate on multiple heart vessels while the heart continues to beat. During the operation, a surgeon cuts a small vertical incision in the chest. A mechanical stabilizing device is inserted to restrict movement of the heart so the doctor can operate on the heart while it is beating. Meanwhile, the rest of the heart keeps pumping and circulating blood to the body.

Many people benefit from off-pump bypass surgery. People at high risk for complications, such as those who have vascular disease, suffered previous strokes, as well as those age 70 or older, usually benefit the most from off-pump bypass surgery. There are fewer cognitive side effects in off-pump patients, less kidney failure requiring dialysis, less red blood cell usage, and fewer infections of chest incisions. The risk of stroke, heart attack during surgery, and death are similarly low in people undergoing both on- and off-pump bypass surgery.

However, not everyone is a candidate for off-pump bypass surgery. The selection of patients who undergo off-pump surgery is often made at the time of surgery, after a cardiothoracic surgeon has evaluated a patient's heart and arteries.

No matter which type of bypass surgery is performed, the results of both on- and off-pump surgeries are excellent. Both substantially improve symptoms in more than 90% of patients. You can have confidence that the experienced and skilled cardiothoracic surgeons of the OSF Saint Anthony Regional Heart Institute will provide you with compassionate care unsurpassed anywhere in the Rock River Valley.

Links
MEDline Plus
http://www.nlm.nih.gov/medlineplus/heartbypasssurgery.html

American Heart Association
http://circ.ahajournals.org/cgi/reprint/107/3/e21.pdf

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What happens after bypass surgery?
After surgery, the patient is moved to a hospital bed, usually in the Critical Care Center. Heart rate and blood pressure monitoring devices continuously monitor the patient for 12 to 24 hours. Family members can visit periodically. Medications that regulate circulation and blood pressure may be given intravenously. A breathing tube (endotracheal tube) will stay in place until the physicians are confident that the patient is awake and ready to breathe comfortably on his or her own.

The patient may feel groggy and disoriented, and sites of incisions — both the chest and the leg, if a segment of blood vessel was taken from the leg — may be sore. Pain controlling medications are given as needed.

Patients usually stay in the hospital at least three to five days and sometimes longer. During this time, some tests will be done to assess and monitor the patient's condition. After release from the hospital, the patient may experience side effects such as:

Many of these side effects usually disappear in four to six weeks, but a full recovery may take a few months or more. When the patient is ready, he or she may be enrolled in a physician-supervised program of cardiac rehabilitation that helps people re-build their strength and confidence. The goal is to return to a normal, active lifestyle.

Source: American Heart Association