Coronary Artery Bypass Surgery

Dottie Krienbring, RN, CRNFA, Husam Balkhy, MD, and Susan Arnsdorf, RN, BSN Cardiac surgeon Husam Balkhy, MD, with Dottie Krienbring, RN, CRNFA (left), and Susan Arnsdorf, RN, BSN.

Surgeons at the University of Chicago 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 regularly perform minimally invasive bypass surgery through small incisions at the side of the chest.

People who have minimally invasive coronary bypass surgery recover faster, have significantly less pain, and experience fewer post-surgical complications than those who undergo traditional open-heart coronary bypass surgery.

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:

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 for certain complications, such as stroke and organ failure.

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.

TECAB: Totally Endoscopic Coronary Artery Bypass Surgery
Totally endoscopic coronary artery bypass (TECAB) surgery is a closed-chest procedure performed through tiny ports. TECAB is done robotically with the assistance of the da Vinci Surgical System.

Comparison of Coronary Artery Bypass Surgery Approaches

  Beating-Heart, Off-Pump Open Chest Traditional, Open Chest Totally Endoscopic Bypass (TECAB)

Keeps the breastbone intact (no splitting)

NO

NO

YES

Minimally invasive approach (small incisions)

NO

NO

YES

Performed on a beating heart

YES

NO

YES

Performed with robotic assistance

NO

NO

YES

Eliminates the need for a heart-lung bypass machine

YES

NO

YES

Number of grafts

Varies

Varies

Varies

Typical length of stay in hospital

5 to 7 days

5 to 7 days

2 days

Typical recovery time

8 to 12 weeks

8 to 12 weeks

2 to 3 weeks

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.