Coronary Artery Bypass Surgery
Coronary Artery Bypass Surgery
To learn more about coronary artery bypass grafting (CABG), please visit https://cle.clinic/3b7dqpE
Cardiac surgeons Faisal Baaeen, MD and Edward Soltesz, MD talk about coronary artery bypass graft (CABG) surgery in this informative video.
They describe:
• how blockages are bypassed
• how vessels are used for the bypass graft
• reoperation experiences
• the importance of complete revascularization
• and options such as off pump bypass surgery and minimally invasive surgery
Dr. Bakaeen is the Director of the Coronary Artery Bypass Center at Cleveland Clinic. To learn more about him, please visit https://cle.clinic/2INN9AV
Dr. Soltesz is a cardiovascular and heart transplant surgeon. To learn more about him, please visit https://cle.clinic/3o86RMt
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Content
0 ->
0.96 -> Coronary artery bypass surgery is as the name suggests
5.07 -> when you get a blockage in your coronary vessel.
8.55 -> To treat that, you have two possible ways.
10.86 -> One is to put a stent
13.41 -> and push that narrowing or stenosis open.
17.888 -> Another option is actually bypass it
19.32 -> and in coronary artery bypass surgery
22.5 -> what we do is we bypass that blockage.
24.63 -> We leave that blockage in place, but we go
26.88 -> beyond that blockage and feed that vessel with a new inlet.
31.26 -> For a fresh blood supply
34.556 -> There are three major blood vessels to supply blood
35.94 -> to the heart, the left coronary artery, which divides
38.46 -> into two major branches, and then the right coronary artery
41.88 -> and patients can develop blockages in those arteries
44.13 -> that lead to heart disease.
45.72 -> Coronary bypass surgery is utilizing either a vein
50.1 -> or an artery to bypass the blockages, and the bypasses are
54.45 -> usually placed in a location that is far
57.33 -> beyond the blockage.
59.67 -> Thereby not only treating the blockage that's occurring
63.3 -> at present, but also treating future blockages
66.63 -> for most patients.
67.59 -> You do as many bypasses as necessary to
71.28 -> achieve what's called a complete revascularization, meaning
74.91 -> that you have bypassed every single significant
79.02 -> or sizable vessel to all major territories of the heart.
84.96 -> Cleveland Clinic, for the most part
87 -> invented coronary bypass surgery.
89.692 -> Back in the 1960s
90.57 -> Mason Stones was a cardiologist who happened
93.03 -> upon coronary angiography
95.482 -> and developed really the the first coronary angiogram.
97.98 -> And together with his surgical colleague, Brene Favaro
101.73 -> they worked and were able to do the first coronary bypass
105.27 -> and coronary bypass surgery.
106.71 -> Had a tremendous history here
108.896 -> at the Cleveland Clinic from the early 1970s.
111.7 -> We did far more coronary bypass surgeries here
113.94 -> than anywhere else in the world.
116.28 -> Coronary artery bypass surgery is certainly
118.23 -> the most common operation that heart surgeons perform
121.29 -> and it's actually the most common operation
123.63 -> among heart surgery programs in the country.
126.355 -> But that doesn't mean
127.188 -> that it's the same operation for every patient.
129.78 -> Every patient needs a tailored approach
131.88 -> to coronary revascularization.
134.224 -> So there are multiple approaches
135.057 -> for coronary artery bypass surgery.
136.71 -> The standard approach is utilizing a full sternotomy
139.14 -> which is full splitting of the sternum
142.05 -> and the surgery can be performed
143.46 -> either utilizing the heart lung machine
145.29 -> or what's called off pump technique.
148.144 -> And thereby we use stabilizers to stabilize portions
150.24 -> of the heart to do the bypasses we need to do.
153.51 -> We can also perform minimally invasive coronary
155.37 -> bypass surgery.
156.36 -> A lot of those can be performed
157.65 -> through a very small incision between the ribs.
159.99 -> We never wanna compromise quality
162.15 -> for cosmetics because our objective is not to
164.61 -> have a perfect immediate outcome.
167.25 -> Our objective is to have long-term success.
170.52 -> When we look at performing bypass surgery
173.31 -> we use either the mammary artery, a radial artery
176.37 -> from the arm
177.3 -> or a portion of the saphenous vein from the leg.
180.96 -> Now, each of these bypasses lasts certain length of time.
185.403 -> They don't last forever.
186.236 -> The mammary artery by far lasts the longest.
188.4 -> It's one of the only arteries
189.96 -> in the body that really does not develop atherosclerosis.
194.43 -> So multi arterial grafting is by far the best strategy
198.18 -> for performing coronary artery bypasses for patients
201 -> because it gives the most long lasting effect.
204.78 -> Not only do we have high volume cardiac surgery practice
208.71 -> but the patients we get here are very high risk patients.
211.98 -> We accept patients from all over the country, in fact
215.43 -> from all over the world.
216.57 -> Many of them have seen one
218.46 -> two or more surgeons that have declined to
221.73 -> offer those patients surgery because of their high risk.
225.18 -> And the surgeons here are very comfortable dealing
227.16 -> with those patients.
229.24 -> The Cleveland Clinic has long been a leader in reoperative
231.03 -> coronary artery bypass surgery that is new coronary bypasses
234.78 -> in someone who's had bypass surgery before.
237.807 -> We do the largest number
238.74 -> of those cases yearly than any other center.
241.77 -> What we do to achieve excellent results is
245.07 -> having a great team approach.
246.96 -> We have excellent surgeons, we have excellent support
250.86 -> and we use grafts and techniques that ensure that
255.78 -> the patient will have not only excellent short-term outcomes
259.38 -> and very low complication rate
261.81 -> but also excellent long-term results.
264.84 -> I think a lot of patients before heart surgery
267.27 -> don't actually fully understand how poorly they feel
271.5 -> and what's rewarding is seeing them return
273.78 -> to what they were seeing them really be able to
276.27 -> enjoy life again.
277.93 -> ♪
279.93 ->
Source: https://www.youtube.com/watch?v=Cp59BCMVHHc