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Bypass surgery is a commonly performed procedure for patients with blocked coronary arteries when medications, ballooning, or stenting are no longer effective. This surgery aims to restore blood flow to the heart muscle by diverting blood around clogged arteries using grafts. In advanced cases of coronary artery disease, bypass surgery may be considered the most comprehensive, effective, or necessary treatment option.

Approaches
Minimally Invasive

Off-pump surgery

Entry through a median sternotomy without stopping the heart and without using the heart-lung machine.

Special equipment and techniques allow the surgeon to perform the procedure safely and efficiently.

On-pump beating heart surgery

Uses the heart-lung machine without stopping the heart.

Suitable for patients with poor heart function or complex artery conditions.

Provides more space and ease for bypass connections, reducing the need to manipulate the heart excessively.

MIDSCABG and MVST

Small incision on the front side surface of the chest, below and left of the left nipple.

Bypasses all three arteries of the heart from a small chest wall incision.

Advanced technology allows for comprehensive bypasses through a minimally invasive approach.

Hybrid bypass procedure

Combines surgical and cardiological techniques for complete revascularization.

Surgeon performs some bypasses through a small incision, while the cardiologist completes the procedure with stenting.

Performed in a single operation in an advanced hybrid operating theatre.

Open Heart

Off-pump surgery

Requires a median sternotomy, but the heart continues to beat during surgery.

Special equipment, such as heart positioning devices and suction tools, are used.

On-pump beating heart surgery

The heart is connected to a heart-lung machine without being stopped.

Suitable for patients with poor heart function, thin or calcified arteries, or significant fat tissue or adhesions on the heart surface.

Provides more stability and allows for easier bypass connections without manipulating the heart excessively.

On-pump beating heart surgery

Combines surgical bypasses with stenting performed by a cardiologist.

Used when all necessary bypasses cannot be placed through a small chest wall incision.

Offers full revascularization and can be completed in a single operation.

Conditions treated
Minimally Invasive
  • Coronary Artery Disease
  • Blockages That Cannot Be Treated With Medications, Ballooning, or Stenting
  • Multiple Artery Blockages Requiring Comprehensive Revascularization
  • Redo Surgeries
Open Heart
  • Coronary Artery Disease
  • Multiple Blocked or Narrowed Coronary Arteries
  • Failed Previous Treatments (Medications, Ballooning, or Stenting)
  • Combined Heart Conditions Requiring Surgical Intervention
  • Redo Surgeries
What to expect
Before Surgery

Minimally Invasive & Open Heart

  • Thorough evaluation including detailed medical history, physical examination, and advanced imaging (e.g. CT scan) to tailor the surgical plan.
  • Consultation with (Adj) Professor Theo Kofidis to discuss minimally invasive & open heart options, their potential benefits & risks, and if patient qualifies for minimally invasive surgery.
During Surgery

Minimally Invasive

  • General anaesthesia is administered.
  • Precise bypass of blocked coronary arteries using specialised instruments through small incisions, minimising trauma to surrounding tissues.
  • Utilisation of advanced technologies such as robotic assistance and specialised imaging for enhanced precision.

Open Heart

  • General anaesthesia is administered.
  • Bypass of blocked or narrowed coronary arteries using open heart surgical methods, which involve opening the chest cavity.
  • Application of advanced surgical technologies and methods to ensure accurate procedure execution and optimal outcomes.
After Surgery

Minimally Invasive

  • Usually 1 day in ICU & 3-4 days in general ward.
  • Faster mobilisation and return to daily activities.
  • Follow-up appointments to monitor healing progress and overall cardiac health.

Open Heart

  • Usually 2 days in ICU & 5-7 days in general ward.
  • Slower mobilisation while in recovery.
  • Follow-up appointments to monitor healing progress and overall cardiac health.
Benefits
Minimally Invasive
  • Smaller incisions
  • Minimal scarring
  • Faster mobilisation & improved recovery
  • Less infection
  • Less blood loss
  • Less trauma
  • Less arrhythmia
  • Better lung function in the early stage
  • Better cosmetic effect
Open Heart
  • Suitability in certain complex & high-risk cases
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