Bridging narrow or blocked vessels
The bypass surgery is performed for coronary heart diseases. At first a coronary angiography is performed with a catheter, to determine and quantify the narrowing in the cardiac vessels. A team of doctors then decides, which available option brings the best results for the patient. Placing a stentA tube that keeps the passageway of a vessel openedis the first choice in most situations, because it is less invasive than a bypass surgery. However, certain constellations might arise, that make a bypass surgery unavoidable, because it offers the best long-term results for the patient. In situations, where mainly the left side of the heart is affected by the disease, the bypass surgery is the gold standard.
Therapy evaluation in the Heartteam
To proceed with a bypass surgery, the chest must be opened. A heart-lung machine is usually used to unload the heart and provide the best setting for the surgical team. Through the bypasses, fresh blood is diverted to the areas of the heart muscle that are undersupplied. These diversions consist of the body's own vessels, such as the left or right chest wall artery (Mammaria), the radial artery from the arm or (increasingly rarely) veins from the leg. The arteries are preferred, because they ensure the best long-term results. The decision to use a stent or bypass will be made with the entire HeartTeam to ensure, that the best procedure is selected for each patient.
Minimally invasive hybrid interventions
Hybrid interventions are currently also on the rise in this area. The guiding principle here is “The best of two worlds”. For example, in the case of a bypass surgery, it can be decided to use arteries for the new blood supply (bypasses) and to treat other target vessels with stents in a second session. We would be happy to inform you about all these alternatives during a consultation / second opinion.
What is a MIDCAB?
MIDCAB - is the minimally invasive bypass surgery. It can be used in certain situations. In this situation, the whole operation is done through a 5cm incision under the left nipple. This consists of a bypass from the left internal mammary artery (LIMA) to the main vessel on the heart, namely the RIVA (lat. Ramus Interventricularis Anterior). This is done without a heart-lung machine and usually takes 90 minutes. The long-term results of this operation are excellent and surpass the stent. But it is not always possible to do this procedure.