Baptist Hospital East : Heart Services

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Surgeons at Baptist Hospital East are performing a procedure that combines the benefits of traditional heart surgery with new technology that allows them to bypass clogged arteries and veins without using a heart bypass machine.

Coronary Artery Bypass Graft (CABG) surgery consists of bypassing clogged arteries to the heart. This procedure uses veins taken from the legs or mammary arteries taken from the chest wall to bypass the heart arteries that are clogged with cholesterol plaque.

Surgeons use an incision in the breast bone, also known as a sternotomy, to see the heart muscle during a typical CABG surgery. In order to bypass the clogged arteries and attach harvested veins or arteries to the heart muscle, the heart must be stopped during the procedure, requiring the use of a heart bypass machine.

The Off-Pump Coronary Artery Bypass (OP-CAB) procedure was developed as surgeons continued to look for ways to combine the benefits of CABG surgery without relying on a heart bypass machine. This procedure utilizes the same sternotomy incision, but patients do not have to have their heart stopped or their blood circulated through a bypass machine. Instead, surgeons perform the procedure on the beating heart.

Using a heart stabilizer, surgeons can restrict the movement of the heart, which provides enough space to perform the delicate anastomosis (connection) of the harvested veins and arteries from the aorta past the clogged coronary arteries. The result is an adequate blood supply to the heart muscle.

The first OP-CAB procedure at Baptist Hospital East was performed in June 1998.

One of the most impressive aspects of the OP-CAB procedure is the ability to restore the blood supply to the heart (revascularization) while avoiding the pitfalls of the heart bypass machine. Bleeding is substantially reduced, which results in fewer blood transfusions. Complications with the kidneys and lungs are minimized as well as potential neurological complications sometimes associated with the heart bypass machine.

This type of surgery is better for those patients who, because of existing medical problems or advanced age, might not do as well on the heart bypass machine. Shorter surgical time, decreased anesthesia usage, earlier extubation from the ventilator and earlier mobilization of the patient are all benefits of the OP-CAB procedure.

However, all patients are not candidates for the OP-CAB surgery.

The size of the heart and its overall condition are important because the heart has to be a certain size for the suturing to be safe. Since the procedure is so delicate, it is more difficult for surgeons, but is providing better results for patients. Perhaps the greatest benefit to the patient is the quicker recovery, fewer post-operative complications, and shorter hospital stay.