It involves making a large chest incision to
expose your heart and arteries.
It requires stopping your heart and
connecting you to a heart-lung bypass machine that takes over the work of your
heart and lungs.
Because of this level of invasiveness, the procedure can cause
several complications. Surgeons have developed several new methods that
minimize the invasiveness and risks involved with CABG surgery. But minimally invasive CABG surgery is not available everywhere. And minimally invasive CABG surgery is not right for everyone.
An enlarged heart (cardiomegaly) may have various causes. But it's usually the result of high blood pressure (hypertension) or coronary artery disease.
An enlarged heart may not pump blood effectively, resulting in congestive heart failure. Cardiomegaly may improve over time. But most people with an enlarged heart need lifelong treatment with medications.
Beating-heart surgery is different from the standard CABG surgery. During a standard CABG procedure, your heart will be stopped and you
will be connected to a heart-lung bypass machine. Beating-heart surgery (BHS)
is unique because the procedure is performed while your heart is still beating, without the heart-lung bypass
There are two main types of beating-heart surgery (BHS), which is
also called minimally invasive CABG surgery:
Minimally invasive direct coronary artery bypass
Off-pump coronary artery bypass (OPCAB)
Minimally invasive direct coronary artery bypass (MIDCAB) surgery
differs from traditional CABG surgery in two ways. First, the MIDCAB procedure
does not use the heart-lung bypass machine. Second, your surgeon will cut
several small incisions (thoracotomies) in your chest to access your coronary
arteries instead of the one large incision (sternotomy) used in traditional
CABG surgery. These smaller incisions expose only the sections of your arteries
that require grafts, instead of your entire heart. As a result, you have a lower risk of infection. You also do not have the large scar associated with traditional CABG surgery.
The main disadvantage of MIDCAB is that it cannot be used to treat
several diseased vessels, especially if arteries on both the left and right
sides of the heart are blocked. The limited number of small incisions made
using MIDCAB makes it difficult to treat more than two coronary arteries during
the same surgery.