What is off pump CABG?
Off pump CABG enables the surgeon to accomplish the bypassing of the heart circulation by sewing grafts on the beating heart. The techniques we use have been developed and refined since the mid 1990’s. During surgery the heart is carefully manipulated to keep the blood pressure and rhythm normal. A special stabilizer is employed to keep the target vessel still and the bypass graft is constructed. CVT Surgical Center has been performing OPCABG since 1998 and our surgeons have an experience of over 3000 cases. The advantage is the avoidance of the use of the heart-lung machine.
Am I a candidate for Off Pump Surgery?
All patients who need bypass grafts alone are considered potential candidates. The techniques used for an individual operation depend on the patient’s anatomy, general health, and surgeon preference. If you need a heart valve repaired or replaced the operation will be performed using cardiopulmonary bypass.
What are the advantages to the patient?
The advantages accrue from the avoidance of the heart-lung machine. Clear advantages are less need for transfusion, less risk of infection, less post operative neurological problems and lower cost. The operation may also be preferable for patients with serious lung, kidney, or liver disease. Most studies show a slightly shorter hospital stay with off pump surgery.
Where is the incision?
The primary incision is known as a median sternotomy and is a vertical incision over the breastbone and is usually about 6 inches in length. If a vein is harvested from the leg a 1 inch incision is made just above the knee. Veins to be used as bypass grafts are harvested with an endoscopic technique using a scope with a camera and video monitor. We refer to this as Endoscopic Vein Harvest. It has dramatically reduced post op leg pain and wound infection. If a radial (arm) artery is used the patient will have an incision in the forearm.
I have diabetes, will this affect the operation?
One third of the patients needing coronary artery bypass grafting have diabetes. In fact surgery rather than stents may be preferable in this group. The patients glucose is closely monitored and treated both during the operation and in the post op period. When tolerating a diet usually in a day or two the patient resumes his home medications.
What about my medicines after surgery?
Your cardiologist will assist in placing you back on your home medicines at the appropriate point after surgery. In general, medications for diabetes, hypertension, and cholesterol will need to be continued at home.
What is the recovery period?
The average patient stays in the intensive care unit 1 night and 4 or 5 days in the hospital. The patient then is discharged home and gradually increases activity over the next 4 to 6 weeks when full recovery is achieved.
What is the mortality rate?
The mortality rate from heart surgery depends on the patient’s overall health, age, heart function, and magnitude of the surgery. The overall mortality rate from Off Pump CABG at CVT Surgical Center is 1%.
Can I stay alone after surgery?
You may, although most patients stay with a family member or friend for the first 1 or 2 weeks.
Will I need home health?
All patients are assigned a home health visiting nurse. They will check on the patient as needed usually a couple of times a week for the first few weeks.
When can I drive?
This is an individual decision. Most patients wait to drive until their first post op visit at 3 or 4 weeks. Many young and active patients drive sooner if they are not in pain and not taking pain medications.
When can I go back to work?
Patients performing a desk job may return to work in 3 or 4 weeks. Patients who work hard physically usually take 6 to 8 weeks off.