Types of Surgical Bypass Procedures

Coronary artery bypass graft (CABG) surgery is a common and potentially effective option for managing a blockage of blood flow to the heart.

A surgical bypass is a type of heart surgery that may be performed to treat coronary artery disease. In essence, the procedure involves utilizing healthy blood vessels taken from another part of the body to redirect the flow of blood around a blocked portion of an artery. The goal is to improve the delivery of oxygen and nutrients to the heart muscle.

What Is Coronary Artery Disease?

Over time, the major blood vessels that supply oxygen and nutrients to the heart can become narrowed due to a buildup of cholesterol-containing deposits (plaque). As the arteries become narrower, blood flow to the heart is reduced, which can lead to symptoms such as chest pain (angina) and shortness of breath. A full blockage can cause a heart attack.

What Does a Surgical Bypass Involve?

To obtain the blood vessel (graft) needed for the surgical bypass, a surgeon will remove a piece of a vein from the patient’s leg or a piece of an artery from the patient’s chest or wrist. The surgeon will then attach the graft to the blocked coronary artery, placing one end of the graft above the blockage and the other end below it. Blood flow will then bypass the blocked area of the artery by traveling through the newly created channel to reach the heart muscle.

Traditional Bypass Surgery

A traditional surgical bypass procedure involves making a large incision in the chest and temporarily stopping the heart from beating. To open the chest, the surgeon will cut the breastbone (sternum) in half lengthwise and spread it apart to access the heart. Then, the surgeon will place tubes in the heart so blood can continue to be pumped throughout the body with the assistance of a heart-lung bypass machine.

Minimally Invasive Bypass Surgery

While the traditional open-heart approach to bypass surgery is still widely used and preferred in many situations, less invasive techniques have been developed to bypass blocked coronary arteries. For instance, other types of surgical bypass procedures include:

• Off-pump bypass surgery – Performed without stopping the heart
• Keyhole bypass surgery – Performed through several small incisions
• Robotic bypass surgery – Performed with the assistance of a highly precise mechanical device
• Hybrid coronary revascularization – Performed as a hybrid procedure to stent some blockages and bypass others

What to Expect After a Surgical Bypass Procedure

Immediately after surgery, the patient will be taken to the intensive care unit (ICU), where his or her electrocardiogram tracing, blood pressure, breathing rate and oxygen levels will be monitored for several hours. In approximately 24 hours, the breathing tube will be removed and the patient will be encouraged to breathe deeply and cough hard to clear fluid from his or her lungs. Then, the patient will be moved to a post-surgical unit, where he or she will continue to recover for several days, gradually increasing his or her activity and introducing solid foods into his or her diet.

A nationally ranked center for cardiology and heart surgery, Tampa General Hospital provides world-class cardiac care in the Tampa Bay area. Utilizing the latest techniques and technologies, our team performs complex heart surgeries, including surgical bypass procedures, at high volumes.