Coronary Artery Bypass Grafting (CABG) is the most common surgical treatment for acquired heart disease. With this method, a blood vessel taken from another part of the body is used to route blood around blockages in the coronary arteries to restore adequate circulation of blood to the heart. NewYork-Presbyterian offers two types of CABG surgeries: traditional CABG and minimally invasive CABG.
During a traditional CABG, the surgeon makes an incision down the center of the chest and through the breastbone (sternum) to gain access to the heart. The heart is temporarily stopped and the patient's blood is shunted into a heart-lung machine, which substitutes for the beating heart and lungs during surgery. Blood vessels from the chest, arms, or legs are placed in the heart to take on the work of the diseased coronary vessel. These donor vessels can be relocated safely because other blood vessels can adequately supply the part of the body from which they are taken. Following completion of the bypass procedure, the heart is stimulated electrically to re-establish its beat, the patient is taken off the heart-lung machine, and the incision in the chest is closed.
In certain cases, a patient may be a candidate for minimally invasive CABG. Using this method, a small (2-3 inch) incision is made in the tissue layer between the ribs. This method – made possible by a specialized surgical robot and a heart stabilizer developed by our surgeons – is associated with less chest trauma, less post-operative discomfort, shorter hospital stays, and a faster recovery time than traditional CABG.
In many cases, CABG can be performed without the use of the heart-lung machine. With this "off-pump" (also called "beating heart") technique, a mechanical stabilizing device is used to restrict the movement of the heart so that the surgeon can perform surgery while the heart is still beating. Patients may be given a drug to slow the heart rate, but the heart maintains its own rhythm without the assistance of the heart-lung machine. The main benefits of off-pump surgery are related to the avoidance of the heart-lung machine and clamping of the aorta, and may include a reduced risk of stroke and bleeding in certain patients.