Coronary Artery Bypass Graft (CABG) - Open Heart Vs Minimally Invasive Cardiac Surgeries

Coronary Artery Bypass Graft, the most commonly performed heart surgery is done
as both conventional Open Heart Surgery as well as a minimally invasive surgery.In
Comparison to the conventional Open Heart Surgery, the advanced treatment technique
– minimally invasive Cardiac Surgery is on a rise for treating various heart
ailments.

Coronary Artery Bypass Graft is performed in conditions such as Arteriosclerosis
(atherosclerosis), Coronary Artery Disease (CAD), any occlusion (obstruction)
or for any diseased arteries. CABG involves bypassing blockages in coronary
arteries with a blood vessel taken from another part of the patient's body.
The bypass reroutes the blood flow by bypassing the diseased tissue and providing
uninterrupted blood flow to the heart.

Open Heart Bypass Surgery which is the conventional Cardiac
Bypass Surgery involves performing an incision or cut over the
sternum and dividing it to reach the heart. The graft is taken from Great Saphenous

Vein from the patient’s leg for the bypass procedure. Now-a-days Internal
Mammary Arteries are the treatment of choice for the graft because it remains
far longer unobstructed as compared to Greater Saphenous vein. The salient feature
involved in this surgery is the use of a Heart-Lung Machine which provides an
uninterrupted circulation and oxygenation to the blood while the heart is stopped
during the surgery. On completion of the bypass surgery the heart is restarted
and the chest wall is closed. The patient is removed from the heart-lung machine.
The total hospital stay of 7-10 days is expected with an Open Heart Surgery.

Minimally Invasive Cardiac Bypass Surgery, the latest treatment technique for
performing Coronary Artery Bypass Graft is the advanced treatment technique
which involves invasion onto the chest wall through a small incision. The procedure
is commonly known as Key-hole Heart Surgery. The peculiar feature of this surgery
is that a very small incision is made on the chest wall and within the confined

space the heart is beating without the use of a lung-heart machine. The technique
is used for the pathologies involved in the Left Anterior Descending Artery
and Right Coronary Artery. For bypass, Internal Mammary Artery is used. This
technique has a fewer complications and the recovery period is around 12-24
hours and the hospital stay is usually about 3-4 days.

On - Pump Vs Off – Pump Cardiac Surgery

While performing a CABG, when the surgeons use Heart-Lung Machine, then it is
called On-Pump CABG. The rationale for using this machine is providing blood
supply to the rest of the body when heart is stopped. This machine does the
work of a heart and lung. The cannulas are placed in the heart to drain the
impure blood to the pump where it is purified and pumped back into the patient.
This works even when the heart is stopped with specialized medications and is
still nourished. During this time the grafts are constructed and at the end
of the procedure the heart is restarted. When the adequate function has been
resumed, the bypass machine is disconnected and the pipes are withdrawn from
the heart.

An Off Pump CABG is the newer method of performing CABG. It is performed so
as to keep heart beating and without the use of heart-lung machine. The technique
involves attaching new grafts to the heart while it is constantly moving and
filled with the blood. Special devices are used to stabilize the heart. This
technique is a newly evolved technique to reduce the risks involved with an
Open heart surgery such as stroke and decrease in higher mental functions.

Open Heart Surgery Vs Minimally Invasive Cardiac Surgery – The differences

• Whereas the conventional CABG surgery requires a 10"-12"
incision to separate the sternum, MIDCAB surgery requires either a 3"-5"
incision placed between the ribs, or may be done with several small incisions.

• The CABG is an on pump procedure thus requires a heart lung machine,
while the MIDCAB is a beating heart surgery does not require the heart lung
machine.

• MICAB surgery is more economical, results in a faster recovery, has
fewer complications, and causes less pain after surgery.

• The procedure is mostly indicated when only 1-2 arteries are involved,
unlike the conventional CABG, which is generally indicated when 3 or more coronary
arteries have occlusion.

It is important to note that although MICAB procedure has many advantages over conventional open heart CABG, not everyone is a candidate for MICAB. Whether a patient will benefit more from MICAB or Open heart surgery can be decided after the cardiac surgeon reviews the medical details of the patient.

Indicure is the leading healthcare services company in India providing heart surgery in India with the most established cardiac surgeons at best heart hospital at low cost. The patients come from US, UK, Australia, Canada, New Zealand, Zimbabwe, Kenya, Tanzania, Nigeria and many other countries for quality and affordable heart surgery in India. For more information, log onto http://www.indicure.com/treatments/cardiac-procedure/cardiac-surgery/open-heart-bypass-surgery-cabg.htm and http://indicure.com/treatments/cardiac-procedure/cardiac-surgery/minimally-invasive-heart-bypass-surgery.htm