Coronary Artery Bypass Surgery

Surgeons at the University of Chicago Medical Center take an uncommon approach to coronary artery bypass surgery, a common heart procedure performed to detour blood flow around blocked arteries. Rather than cutting the breastbone (sternum) to access the heart, our surgeons can use a sophisticated robotic device to perform coronary bypass surgery through tiny, fingertip-size slits at the side of the chest. This is a totally closed-chest approach -- the chest is not opened during surgery.

People who have this innovative type of bypass surgery -- called totally endoscopic coronary artery bypass (TECAB) -- recover faster, have significantly less pain, and experience fewer post-surgical complications than people who undergo traditional open-heart coronary bypass surgery.

Our surgical team includes a surgeon who has played a key role in the development of minimally invasive robotic coronary bypass surgery and has performed more of these surgeries than any other surgeon in the world.

About Coronary Artery Bypass Surgery

Coronary artery bypass graft surgery is a time-tested procedure used to detour blood flow around blocked arteries. All forms of bypass surgery involve removing a "clean" vessel (graft) and attaching it to the areas around the blocked artery in order to restore blood flow. The goal of the surgery is to improve blood flow and alleviate chest pain and other symptoms.

Our physicians are highly skilled in determining the best approach for each patient's bypass surgery, taking into account the number and location of blocked vessels, the patient's prior history of heart surgery, and other factors such as age and co-existing conditions. In most cases, our experts can offer minimally invasive options that spare the breastbone, and don't require stopping the heart and using a heart-lung bypass machine.

Surgeons here also prefer using arterial grafts rather than vein grafts because arterial grafts better withstand blood pressure over time, and they are less likely to develop blockages than vein grafts. The use of arterial grafts reduces the need for re-operation significantly.

University of Chicago cardiac surgeons frequently perform bypass surgery on people considered high risk and on those who have been turned down for surgery at other hospitals.

Types of Coronary Artery Bypass Surgery

Our heart surgeons offer the following bypass surgery approaches:

Totally Endoscopic Coronary Artery Bypass Surgery (TECAB)
TECAB is an innovative minimally invasive method to perform bypass surgery with the use of the da Vinci Surgical System, a sophisticated robotic device. It's a totally closed-chest procedure, meaning that the entire surgery is performed through four to five tiny incisions at the side of the chest, without cutting the breastbone or opening the rib cage. TECAB procedures are done on a beating heart and do not require use of a heart-lung machine.

Coronary Artery Bypass Surgery through a Lateral Thoracotomy (ThoraCAB)
If TECAB is not an option, our surgeons consider the ThoraCAB approach, which is performed through one small, 3- to 5-inch incision on the side of the chest. Like TECAB, this procedure provides the benefits of minimally invasive surgery, such as faster recovery, less pain, and no splitting of the breastbone. ThoraCAB is typically performed with robotic assistance and frequently on a beating heart.

Beating-Heart "Off-Pump" Coronary Artery Bypass Surgery
When an open-chest approach is required, it's preferable to perform the surgery on a beating heart, without the use of the heart-lung bypass machine. University of Chicago surgeons have performed beating-heart bypass surgery for several years, and frequently on patients considered high-risk.

Traditional, Open-Chest Coronary Artery Bypass Surgery
Traditional open-chest coronary bypass surgery has been performed for decades. This technique involves making an incision through the breastbone (sternotomy) to gain access to the heart. The heart is stopped and a heart-lung bypass machine is used to oxygenate and circulate blood during surgery.

Comparison of Coronary Artery Bypass Surgery Approaches

	TECAB	ThoraCAB	Beating-Heart, Off-Pump Open Chest	Traditional, Open Chest
Keeps the breastbone intact (no splitting)	YES	YES	NO	NO
Avoids spreading the ribs	YES	NO	NO	NO
Minimally invasive approach (small incisions)	YES, 4 to 5 small, fingertip-size incisions	YES, 3- to 5-inch incision at side of chest	NO	NO
Performed on a beating heart	YES	YES	YES	NO
Performed with robotic assistance	YES	YES, typically	NO	NO
Eliminates the need for a heart-lung bypass machine	YES	YES	YES	NO
Number of grafts	Up to 3, can be 5 with hybrid approach	Any	Any	Any
Typical length of stay in hospital	1 to 3 days	2 to 4 days	5 to 7 days	5 to 7 days
Typical recovery time	1 week	1 week to 10 days	4 to 8 weeks	4 to 8 weeks

*Other factors, such as the location of blockages, the health of the patient, and the patient's previous surgical history affect which surgical approach is selected. Hospital stay and recovery time may vary depending on associated risk factors.