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 smaller incisions. This is a less invasive approach -- the sternum is not opened during surgery.

The da Vinci Surgical System enables physicians to perform bypass surgery through tiny incisions.

People who have minimally invasive robotic bypass surgery recover faster, have significantly less pain, and experience fewer post-surgical complications than people who undergo traditional open-chest coronary bypass surgery. In some cases, these procedures are performed in collaboration with cardiologists who insert stents to prop open some of the blocked arteries, an approach called hybrid 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.

We're the only hospital in Illinois to make Worth magazine's elite list of the nation's top 25 hospitals for coronary artery bypass surgery.

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 many 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 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:

Robotically Assisted Coronary Artery Bypass Surgery through a Mini Thoracotomy (ThoraCAB)
The ThoraCAB approach is performed through one small, 2- to 5-inch incision on the side of the chest. 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 using the da Vinci Surgical System. The robot allows the surgeon to harvest internal mammary arteries from the chest wall to be used for grafts. Because the robot gives the surgeon a magnified view inside the chest, vessel harvest can be achieved with less pain and trauma for the patient. The grafts are then hand sewn through a small incision on the side of the chest.

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. 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. Our surgeons evaluate each patient to determine if this is an appropriate approach.

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.

Comparison of Coronary Artery Bypass Surgery Approaches

*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.