Hybrid heart bypass surgery

Hybrid heart bypass surgery

Overview

Hybrid heart bypass is a combination of minimally invasive approaches used for direct coronary artery bypass (MIDCAB) or totally endoscopic coronary bypass (TECAB) and a stenting procedure that offers the best of both techniques. Your surgeon may recommend a hybrid heart bypass procedure if you have multiple blockages in your arteries and are not a suitable candidate to have all blockages addressed by minimally invasive surgery. These combined procedures allow your surgeon to perform heart surgery through small incisions that allow the surgeon to guide catheters, other devices, a balloon and a stent through your arteries.

When arteries become blocked or narrowed, blood can't flow properly and leg muscles don't receive enough oxygen. Too much cholesterol can cause atherosclerosis, which is a hardening, narrowing, or blockage of the arteries due to widespread build-up of plaque in the arteries. This condition also may reduce blood flow to the heart and brain. Peripheral artery disease (PAD), also referred to as peripheral vascular disease (PVD), may be a sign of atherosclerosis. It is a common but serious condition in which narrowed arteries and veins outside of the heart — such as those in the arms, legs, neck or near the kidneys or intestines — reduce blood flow to the limbs, most often the legs. Left untreated, PVD can lead to heart attack, stroke, high blood pressure, kidney failure, heart disease, heart failure or even amputation. Bypass surgery creates a new pathway through which blood can flow by bypassing a blocked area in your vein or artery.

Diagnosis

Northwell offers a full range of the most advanced diagnostic technologies, including ultrasounds, pulse volume recording, computed tomography (CT) scans and magnetic resonance imaging (MRI), with which vascular specialists diagnose PVD in arteries such as:

  • Brachiocephalic (leading from the heart to the head)
  • Iliac and femoral (supplies the arms and legs)
  • Mesenteric (supplies the intestines with blood)
  • Renal (supplies the kidneys)

Types

  • MIDCAB (minimally invasive direct coronary artery bypass)By avoiding sternotomy and conventional cardiopulmonary bypass operations, MIDCAB is a very good option for single-vessel LAD (left anterior descending) coronary artery disease.
     
  • TECAB (totally endoscopic coronary artery bypass surgery)This minimally invasive approach using the daVinci robot system enables the surgeon to have precise movements and an excellent view of the coronary arteries. Both on-pump and off-pump (OPCAB) operations can be performed to treat single and multivessel disease.

Results

This newer approach offers you the long-term benefits of surgery and stenting as well as having two procedures performed at the same time rather than on different days, to reduce stress on your body. Other benefits of hybrid procedures include reduced blood loss, smaller incisions, a shorter hospital stay and quicker recovery time.

Preparation

 

Coronary artery bypass surgery requires an in-hospital stay of several days or longer, depending on your condition and your doctor’s decision. Your doctor will explain the procedure to you and offer you the opportunity to ask any questions you might have about the procedure. In addition to getting your complete medical history, your doctor may perform a complete physical examination to ensure that you are in good health before undergoing the procedure.

You may undergo blood tests or other diagnostic tests. You will be asked to sign a consent form that gives your doctor permission to do the tests. Read the form carefully and ask questions if something is not clear. Based on your medical condition, your doctor may request other specific preparation.

Notify your doctor if:

  • You are pregnant or suspect that you are pregnant
  • You are sensitive to or allergic to any medications, iodine, latex, tape or anesthetic agents (local and general)
  • You are taking prescription or over-the-counter medications or herbal supplements
  • You have a history of bleeding disorders or are taking any anticoagulant (blood-thinning) medications, aspirin or other medications that affect blood clotting
    • It may be necessary for you to stop some of these medications prior to the procedure.
    • Your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.
  • You have a pacemaker
  • You smoke:
    • You should stop smoking as early as possible prior to the procedure.
    • This may improve your chances for a successful recovery from surgery and benefit your overall health.

You will be asked to fast for eight hours before the procedure, generally after midnight. Before surgery begins, you will be asked to remove any jewelry or other objects that may interfere with the procedure, and will be asked to remove your clothing and put on a hospital gown. You will also be asked to empty your bladder (go to the bathroom) before surgery. 

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