Coronary artery bypass grafting (CABG) is a surgical technique where blocked or narrowed arteries are bypassed by grafting on a piece of a healthy blood vessel taken from somewhere else in your body. This restores the blood flow to your heart again, heading off serious complications.
Our cardiothoracic surgeons perform hundreds of CABG procedures every year. By treating a high volume of cases, this ensures that our team can offer high success rates, especially for patients who have advanced or complex coronary artery disease. We are one of just a few surgical teams nationwide to offer totally endoscopic robotic CABG, which gives our patients an option that reduces pain and long recovery times.
Endoscopic Robotic CABG
Traditionally, CABG could only be performed through open surgery, which requires a large incision and a sternotomy (separating the breastbone) to access the heart. Only specialized teams can perform robotic CABG.
Our specialized robotic surgery team can perform the heart bypass from start to finish through a few small incisions (7 – 15mm). This reduces the recovery time and the post-surgical pain experienced by the patient, enabling them to go home from the hospital faster and get back to normal life with their symptoms relieved! The risks for robotic CABG are the same as open CABG because ultimately the procedure is the same, it is simply performed with a minimally-invasive approach.
An additional benefit of robotic CABG is that, in certain cases, it can be performed without having to stop the heart and put the patient on a heart-lung bypass machine. For open CABG, the patient’s heart must be temporarily stopped.
Your surgical team will make small incisions in your chest or under your arm and insert the surgical tools and a camera through those small openings. Your surgeon will sit at a computer nearby the operating table and view your heart on a screen that can magnify your arteries up to 10x a normal person’s vision. The robotic arms the surgeon controls are more precise and steady than a human hand.
They will then harvest an artery from your chest and maneuver it in through the incisions to the blocked artery. From there, they will connect the harvested artery to a point below and above the blockage, providing a new way for blood to flow through that artery and into the heart.
For some patients, open CABG may be the best option. In those cases, a sternotomy (an incision through the sternum/breastbone) will be carefully performed to provide the surgeon direct and clear access to the heart and coronary arteries.
As a part of the CABG procedure, patients will go on cardiopulmonary bypass. This means that a heart-lung machine will be used to circulate oxygenated blood throughout the body while the heart is stopped for the procedure. This is done to ensure accuracy and efficiency of the procedure, while also minimizing blood loss.
Why choose Georgia Heart Institute for CABG?
First and foremost, the clinical quality of CABG procedures performed at Georgia Heart Institute is excellent. This is especially crucial when it comes to the complexity and seriousness of advanced cardiac conditions, like multi-vessel, symptomatic CAD.
When compared to national benchmarks and quality metrics established by The Society of Thoracic Surgeons, which is considered the gold standard for data and quality of cardiothoracic surgery, our surgeons consistently achieve outstanding results in clinical care. This means that our patients experience fewer complications, have better outcomes and are discharged sooner than other hospitals across the country.
This dedication to quality care extends beyond the cardiothoracic surgeons that lead the program to encompass a team of highly-trained advanced practice providers, nurses, surgical technologists and multi-disciplinary expertise from imaging, cardiology, intensive care and cardiac rehab. This collaboration at every step of the care journey ensures the best possible experience for patients, while ensuring positive long-term outcomes.
Frequently Asked Questions
Coronary artery disease (CAD) occurs when a fatty substance, plaque, builds up in the arteries that supply the heart with blood. Overtime, this plaque can narrow and stiffen the arteries, limiting blood flow to the heart and making a blockage (heart attack) more likely. When this plaque is extensive and/or it affects multiple vessels, coronary artery bypass grafting (CABG) is one of the most thorough and trusted forms of treatment.
There are a variety of factors that are considered in the treatment of CAD and whether a CABG procedure is the best option. In addition to the overall health of the patient and their medical history, the surgeon will carefully evaluate key characteristics of the disease, including:
- Whether it’s causing symptoms that interfere with/affect quality of life
- The degree of damage/blockage in the artery
- The location of the plaque build-up and which artery is affected
- The presence of other cardiovascular damage/disease
As with any procedure, there are risks associated with the procedure itself and the recovery. The risk of complications for CABG procedures at Georgia Heart Institute, is lower than the national benchmark. Plus, our cardiothoracic surgical team is extremely attuned to the risks and possible complications during and following a CABG procedure, so they take proactive and preventative measures to minimize risk. For CABG, possible risks include:
- Bleeding (during and after surgery)
- Blood clots (stroke/heart attack)
- Infection of the incision site
- Breathing problems (short-term and long-term)
- Kidney failure
- Heart rhythm abnormalities
- Graft failure
When more than one artery in your heart is blocked, your surgeon may fix each of those blockages during your surgery. Needing more than one bypass does increase the risks of complications during or after surgery, but the overall mortality rate for bypass surgery is very low.
Immediately after your surgery, you will be taken to Ronnie Green Heart Center, our cardiovascular intensive care unit. Ronnie Green is a specialized heart recovery unit with technology and staff that are specially trained to monitor those recovering from heart surgery.
At first, you will likely be on a ventilator to allow the body to heal and to support breathing during the early stages of recovery, but you will then transition to self-sustained breathing. During this time, you may also notice chest discomfort and soreness, which is normal following surgery. Our cardiothoracic surgical and recovery teams will help to provide guidance and support on how to perform breathing exercises that ease pain and minimize risk of pneumonia.
As you continue to heal, you will receive medications, therapies and assistance to support your recovery. In addition to the CVICU, you will receive care in the Cardiac Care Unit and from the Cardiopulmonary Rehabilitation team, all to keep you progressing through each stage of post-surgical recovery and to get you back home.
The average hospital stay for robotic CABG patients is anywhere from 2 to 5 days, while the average stay for open CABG patients is typically 4 to 5 days. Patients are usually able to return to normal activities in 2 – 4 weeks after robotic CABG and 2 – 3 months after open CABG.
Connect with our Program
Referrals are required for surgical services, but our knowledgeable team is always happy to answer your questions and provide next steps. Call 770-219-7099 to discuss your surgery with our team.
If you are a clinician who needs to refer a patient for cardiothoracic surgery, please contact our program directly at 770-219-7099. Our program coordinator can answer any questions you have and help schedule your patient to see one of our board-certified cardiothoracic surgeons.