Minimally invasive coronary bypass surgery

To perform this surgery, the heart surgeon makes a 3- to 5-inch incision or cut in the left side of the chest between the ribs to reach the heart. Muscles in the area are pushed apart, and a small part of the front of the rib called the costal cartilage is removed. The surgeon then locates an artery called the internal mammary artery inside the chest and prepares it to be attached to the blocked coronary artery. Next, sutures are used to connect the two arteries.

The patient is not required to be on a heart-lung machine for this surgery, but general anaesthesia is given so that there is no pain and consciousness during the surgery. A device is then attached to the heart to stabilise it. Certain medications are also given to slow the heart down. A tube is placed in the chest for drainage of fluid, which is later removed in a day or two.

A minimally invasive coronary artery bypass may be recommended if there is a blockage in one or two coronary arteries. When one or more of the coronary arteries or arteries in the heart undergo partial or total blockade, the heart does not receive enough blood. This leads to ischemic heart disease or coronary artery disease, which can cause chest pain or angina.

This procedure is usually done in patients whose symptoms have not been relieved by medications or in whom cardiac rehabilitation has failed. A heart bypass may not be fit for everyone. There are diverse types of coronary artery diseases, so the treatment for those also varies from person to person. Other options that may be recommended instead of minimally invasive heart bypass include angioplasty and stent placement.

Your healthcare team will counsel you about the surgery's risks. The complications of minimally invasive coronary artery bypass procedure are much lower than the open one however, they may include:

• Development of blood clots in the legs that may go up to the lungs
• Loss of blood
• Difficulty in breathing
• Heart attack or stroke
• Brain injury, temporary or permanent
• Pain at the incision site

• Loss of memory or loss of mental clarity: Sometimes referred to as "fuzzy thinking", this condition is much more common with minimally invasive coronary artery bypass than with open coronary bypass
• Infection of the lungs, urinary tract, and chest
• Arrhythmia or abnormal heart rhythms
• Infection of the chest wound: This is more likely to occur if you have obesity, diabetes, or have had coronary bypass surgery in the past
• Postpericardiotomy syndrome: It is the simultaneous occurrence of low-grade fever and chest pain and can last up to 6 months

Share the names of all the drugs you take with your doctor, even supplementary medications or herbs you bought without a prescription.

For several weeks before surgery, you might need to stop taking drugs like aspirin, ibuprofen, and naproxen that make clotting of blood harder. This is because taking these medications may lead to increased bleeding during the surgery. If you are taking clopidogrel, ask your surgeon when you should stop consuming it before surgery and also which drugs you should still take on the day of the surgery.

If you are a smoker, try to quit. Quitting is very hard if you are addicted to smoking; therefore, you can ask your medical team at Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai for help and support regarding the same. There are several therapies and medications that help smokers quit the addiction.

Call your medical team if you have a cold, flu, fever, herpes breakout, or any other illness.

Take a bath and shampoo your hair. A whole-body wash with an antiseptic solution is recommended.

• You will often be recommended not to drink or eat anything from the night before your surgery
• You can rinse your mouth with water if it feels dry, but try not to swallow
• After consulting your doctor, take the medications you need to take with a small sip of water
• You will be informed by the medical team about the time you need to arrive at the hospital

You may be discharged from the hospital 2 or 3 days post your surgery. The doctor or nurse will counsel you about how to care for yourself at home. You will not be able to do strenuous physical activities or return to normal work for 2 or 3 weeks.

Recovery from surgery takes time, and the full benefits of your surgery may not be experienced for upto 3 to 6 months. In most patients who undergo heart bypass surgery, the grafts remain open and function well for many years.

This surgery does not prevent the recurrence of a blockage; however, steps can be taken to slow it down, which include:

• Do not smoke
• Consume a heart-healthy diet
• Do regular exercises
• Keep high blood pressure, diabetes and high cholesterol under control if you have those

Kokilaben Dhirubhai Ambani Hospital is the best Coronary Bypass Surgery hospital in Navi Mumbai. When it comes to cardiac care, experience matters. Our hospital combines the expertise of the best Cardiac Surgeons in Navi Mumbai with world-class facilities and infrastructure to provide advanced cardiac care for all ages, aligned with the national and international healthcare standards. We are committed to delivering quality comprehensive medical care and excellent patient service.