Beating-Heart Bypass Surgery

Every year in Ontario, approximately 7,000 people with coronary artery disease benefit from having bypass surgery. Unfortunately, there are some cases where patients with two or three blocked arteries would benefit from surgical intervention but are not well enough to withstand conventional bypass surgery.

In 2009, Sunnybrook’s Schulich Heart Centre became the first centre in Toronto to perform minimally invasive, beating-heart bypass surgery to fix clogged arteries and improve blood flow to the heart.

Both conventional bypass surgery and minimally invasive coronary artery bypass grafting restore blood flow to the heart when there is a buildup of plaque inside the blood vessels. The advantage of using a minimally-invasive technique rather than the traditional approach is that it allows the surgeon to work on a beating heart through a small chest incision without having to split the breastbone and place patients on a heart-and-lung machine while surgeons work on the stopped heart.

While Sunnybrook cardiac surgeons have been performing conventional bypass surgery successfully for many years, the techniques being offered at Sunnybrook minimize operative risks and patient trauma associated with opening up the chest and stopping the heart. This means patients can often return home after only a few days and resume many normal activities within a couple of weeks rather than a couple of months.

Sunnybrook is one of only a few health sciences centres in Canada currently offering this surgical alternative to traditional bypass surgery.

How it works

During traditional bypass surgery, the surgeon makes a long incision to completely split the breast bone or sternum (sternotomy) and access the heart. Patients are then placed on a heart-and-lung machine which acts as a substitute for their own, which allows surgeons to work on a stopped heart. People who undergo this surgery generally recover in about six-to-eight weeks.

With the minimally-invasive beating heart approach, the surgeon can perform the operation through a tiny incision under the left nipple (four or five centimetres wide) while the heart continues to beat. This technique lowers the risk of complications such as stroke, lung problems and kidney problems which are associated with the use of a heart-and-lung machine. It also means patients have reduced pain and less need for postoperative pain medication, smaller scars, a shorter stay in the hospital and a faster recovery.