At NYU Langone, cardiac doctors perform surgery to improve blood flow in people who have coronary artery disease caused by severe blockages.
This surgery bypasses blockages in the coronary arteries using a graft, which is made from leg vein tissue, one or two internal mammary (chest wall) arteries, or a radial (forearm) artery. This creates a new channel for blood to flow to the heart. Our surgeons typically use multiple arterial grafts for coronary bypass surgery, the most commonly used procedure for coronary artery disease.
Your cardiac team decides whether coronary angioplasty and stenting or coronary artery bypass surgery are best for you. Large clinical trials have shown that certain groups of people have significantly improved long-term results after coronary artery bypass surgery.
Using general anesthesia, the doctor performs a sternotomy, in which he or she makes an incision in the center of the chest and opens the breastbone. He or she places plastic tubes in the heart’s right atrium, where blood enters the organ. These tubes channel blood into a heart-lung machine, which does the work of the heart and lungs during the surgery.
A coronary artery bypass can take up to four hours to complete. You can expect to remain in the intensive care unit for one to two days after surgery. Your doctor monitors you for signs of internal bleeding and arrhythmias, or heart rhythm disorders. The typical hospital stay is approximately five to six days.
During your recovery, your doctor may recommend avoiding driving for up to 3 weeks and lifting anything heavier than 10 pounds for 3 to 4 weeks. Total recovery time is usually four to six weeks.
For some people who require a single bypass, a surgical robot can help the doctor perform a coronary artery bypass. It makes small, precise incisions and uses a camera that provides three-dimensional, high-definition views of the arteries. The doctor controls the robot’s arm with a computer.
The robotic approach enables the surgeon to perform an endoscopic coronary bypass, which involves making four to five incisions in the chest that are less than an inch in size. The chest is not opened during the procedure.
Because the breastbone isn’t opened and the heart isn’t stopped, this procedure requires a shorter hospital stay—typically one to three days. Recovery takes approximately two weeks.
If you have a blockage that affects the left anterior descending coronary artery, your doctor may recommend this procedure, which is a combination of robotic-assisted bypass surgery and coronary angioplasty and stenting.
The left anterior descending coronary artery carries blood to the left ventricle, the lower left chamber of the heart. The left ventricle pumps blood to the aorta, the body’s largest artery, which carries oxygen-rich blood to the body.
In a hybrid revascularization, small incisions are made between the ribs. The thoracic artery, which supplies blood to the chest muscles, is used to bypass the left anterior descending coronary artery. Next, the doctor inserts a metal, mesh stent into the blocked arteries to prevent them from narrowing. Our surgeons perform the bypass surgery first and the angioplasty three days later.
You can go home the day after the angioplasty. The total hospital stay is about five days, and recovery takes approximately two weeks.
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