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Coronary Artery Bypass Surgery (Traditional vs. Beating Heart)

Coronary artery bypass surgery is done to provide "detours" around the partially or completely blocked arteries. With a new open "bypass system" the heart can now receive its much needed blood supply.

Coronary artery bypass surgery is performed to provide relief of angina, to improve the pumping ability of the heart muscle, to prevent heart attacks, and to reduce the use of heart medications, all of which should improve a patient's quality of life. The indications for surgery vary, depending on each patient's symptoms and findings at the time of heart catheterization. Your surgeon and cardiologist will discuss the reasons for recommending surgery to you.

The concept of coronary artery bypass surgery is very simple. Healthy arteries or veins are "harvested" to create “bypass grafts” that channel the needed blood flow around the blocked portions of the coronary arteries. The new section of vessel can come from the mammary artery in your chest, the radial artery in your forearm, or the saphenous vein in your leg. 

The saphenous vein is commonly used for grafts. These veins are used by the surgeon as an alternate vessel to deliver blood to the heart muscle below the point of the blockage. The surgery reroutes the blood flow to supply areas of the heart muscle not receiving enough blood (See Figure 1).

Traditional Bypass Surgery

Coronary artery bypass surgery became routine in the late 1950s with the invention of the heart-lung machine. With "traditional" bypass surgery, surgeons use the assistance of the heart-lung machine along with medications to stop the heart so the bypass can be performed on a motionless field. The heart-lung machine is referred to as a "pump" because it continues to mechanically pump oxygen and nutrients to the body during surgery.

View animation about Coronary Artery Bypass Surgery.

Beating Heart Bypass Surgery

Beating Heart Bypass Surgery differs from traditional bypass surgery in that, as the name implies, it is performed while your heart is still beating. In the past, the surgeon used a heart-lung machine to stop the heart during the procedure. Today it is possible in some cases to perform the surgery without the use of the machine. But, the surgeon may still have a perfusionist (a specialist trained to operate the heart-lung machine) remain on standby during the operation in case the machine is needed.

One of the greatest benefits of this approach is that the surgeons can perform multiple bypass grafts on all areas of the heart, including the backside (posterior), at the same time. What this means is, the surgeon can perform a triple (three bypass grafts), quadruple (four bypass grafts) or more through a middle of the chest incision all off-pump.

Benefits

Your physician may choose the beating heart bypass procedure for you because of benefits such as:
      • Decreased length of hospital stay
      • Less trauma due to the elimination of the heart-lung machine
      • Reduction in need for blood transfusions
      • Fewer cognitive and neurological consequences, such as stroke

Learn more about Beating Heart Bypass Surgery.
Learn more about Endoscopic Vessel Harvesting (EVH).

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