Coronary Artery Bypass Grafts & Endoscopic Vessel Harvesting Explained
Blockages in the blood vessels of the heart (coronary) arteries can create chest pain (angina), breathlessness, or even heart attacks, so finding the best solution for this condition is paramount. For some patients, the relief from symptoms may be the most important outcome, but in others, it is about finding a route that allows them to live a longer, healthier life. Traditionally, the best course of action to relieve symptoms and provide longevity is to consider surgical revascularisation of the heart. This is a very effective treatment, but many patients wish to avoid having their breastbone opened. These days, some surgeons perform this procedure using keyhole coronary bypass surgery. During this procedure, a small cut is made between the ribs over the left chest about 4 to 5 inches long. At the same time, we can collect new bypass tubes, (arteries from the forearm or vein from the leg) using similar tiny keyhole cuts.
To help you get a full understanding of this procedure, we will discuss what a coronary artery bypass graft is, how endoscopic vein harvesting can be much more beneficial than previous methods, and how The Keyhole Heart Clinic can help you.
What Is A Keyhole Coronary Artery Bypass Graft?
Typically, normal bypass surgery would require your breastbone to be broken in order to reach the blocked arteries. Not only would this result in a highly visible, long scar on the chest, but it would also need at least three months to heal. We have also found that this incision is associated with a higher risk of wound infection, pain and bleeding compared to keyhole incisions. With a keyhole coronary artery bypass graft, the breastbone is left intact, which allows you to get your life back on track much sooner. It only requires seven days to heal, with no risk of bone infection and a small scar that can be easily hidden.
During the procedure, we will take an artery from behind the breastbone called the left internal mammary artery. If you need more than one keyhole bypass graft, we will also harvest an artery from the forearm, or a vein from the leg, to bypass these heart vessels. This is one of the most effective ways to offer the best long term results and survival benefit for people with coronary artery disease. These extra tubes can be harvested using a special telescope or endoscope through tiny cuts.
Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014
What Is Endoscopic Vessel Harvesting?
While coronary artery bypass grafts have been a popular procedure for over 50 years, there have been major advancements in how the replacement arteries and veins are harvested. Traditionally, the required tubes would be taken via a long cut that can leave a highly visible scar. For example, if the artery is taken from the leg, a cut from groin to ankle would be made, which can often heal poorly and cause more pain than even the breastbone cut. This is why we prefer to take the bypass tubes (artery or veins) through endoscopic vessel harvesting.
Full radial harvest (Modified from istock Getty Images 504686901_3117x963 (1).jpeg)
Keyhole radial harvest (Modified from istock Getty Images 504686901_3117x963 (1).jpeg)
During the endoscopic vessel harvesting, we will take the artery or vein through two 8mm cuts using a telescope using video images projected on to a screen, so that we can locate and remove the required tube in a minimally invasive way.
What Are The Benefits Of Endoscopic Vein Harvesting?
There are several reasons why we favour this new procedure over the traditional breaking of the breastbone, and they include:
- Less muscle and tissue damage, resulting in less scarring
- Much less pain
- Reduced surgical trauma
- Less risk of wound infections
- Less bleeding
- Faster healing time, allowing patients to resume normal life after around a week
This is a highly successful method of harvesting the required vein or artery. However, every patient is unique, so do not hesitate to contact us for a recommendation on the best course of action for coronary artery disease.
We are one of the few clinics in the UK who offer single, as well as multiple coronary bypass grafting through small incisions without breaking the breastbone. This procedure and other available non-invasive keyhole heart surgeries are quickly becoming one of the preferred ways to treat coronary artery disease for those that are looking to handle the condition with minimal downtime. For more information on our grafts or endoscopic vessel harvesting, please get in touch. Let us help you today.
