Coronary artery bypass surgery, also known as coronary artery bypass graft, is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pain caused by CAD, slow the progression of CAD, and increase life expectancy. It aims to bypass narrowings in heart arteries by using arteries or veins harvested from other parts of the body, thus restoring adequate blood supply to the previously ischemic heart.
Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart, lungs, and other pleural or mediastinal structures.
Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease ; to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation.
Robot-assisted surgery or robotic surgery are any types of surgical procedures that are performed using robotic systems. Robotically assisted surgery was developed to try to overcome the limitations of pre-existing minimally-invasive surgical procedures and to enhance the capabilities of surgeons performing open surgery.
A vascular bypass is a surgical procedure performed to redirect blood flow from one area to another by reconnecting blood vessels. Often, this is done to bypass around a diseased artery, from an area of normal blood flow to another relatively normal area. It is commonly performed due to inadequate blood flow (ischemia) caused by atherosclerosis, as a part of organ transplantation, or for vascular access in hemodialysis. In general, someone's own vein (autograft) is the preferred graft material for a vascular bypass, but other types of grafts such as polytetrafluoroethylene (Teflon), polyethylene terephthalate (Dacron), or a different person's vein (allograft) are also commonly used. Arteries can also serve as vascular grafts. A surgeon sews the graft to the source and target vessels by hand using surgical suture, creating a surgical anastomosis.
Postperfusion syndrome, also known as "pumphead", is a constellation of neurocognitive impairments attributed to cardiopulmonary bypass (CPB) during cardiac surgery. Symptoms of postperfusion syndrome are subtle and include defects associated with attention, concentration, short-term memory, fine motor function, and speed of mental and motor responses. Studies have shown a high incidence of neurocognitive deficit soon after surgery, but the deficits are often transient with no permanent neurological impairment.
An oxygenator is a medical device that is capable of exchanging oxygen and carbon dioxide in the blood of human patients during surgical procedures that may necessitate the interruption or cessation of blood flow in the body, a critical organ or great blood vessel. These organs can be the heart, lungs or liver, while the great vessels can be the aorta, pulmonary artery, pulmonary veins or vena cava.
Off-pump coronary artery bypass or "beating heart" surgery is a form of coronary artery bypass graft (CABG) surgery performed without cardiopulmonary bypass as a treatment for coronary heart disease. It was primarily developed in the early 1990s by Dr. Amano Atsushi. Historically, during bypass surgeries, the heart is stopped and a heart-lung machine takes over the work of the heart and lungs. When a cardiac surgeon chooses to perform the CABG procedure off-pump, also known as OPCAB, the heart is still beating while the graft attachments are made to bypass a blockage.
Totally endoscopic coronary artery bypass surgery (TECAB) is an entirely endoscopic robotic surgery used to treat coronary heart disease, developed in the late 1990s. It is an advanced form of minimally invasive direct coronary artery bypass surgery, which allows bypass surgery to be conducted off-pump without opening the ribcage. The technique involves three or four small holes in the chest cavity through which two robotic arms, and one camera are inserted.
David Coston Sabiston, Jr., M.D.,, F.A.C.S. was an early innovator in cardiac surgery. In 1962, he performed a seminal procedure that paved the way for modern coronary-bypass surgery, grafting a vein from a patient's leg to bypass a blocked coronary artery during open-heart surgery. The patient died from unrelated complications, but Sabiston's technique and other surgeons' improvements on it led to the development of surgical coronary revascularization as it exists today.
A myocardial bridge (MB) is a congenital heart defect in which one of the coronary arteries tunnels through the heart muscle itself (myocardium). In normal patients, the coronary arteries rest on top of the heart muscle and feed blood down into smaller vessels which then take blood into the heart muscle itself. However, if a band of muscle forms around one of the coronary arteries during the fetal stage of development, then a myocardial bridge is formed – a "bridge" of heart muscle over the artery. Each time the heart squeezes to pump blood, the band of muscle exerts pressure and constricts the artery, reducing blood flow to the heart. This defect is present from birth. It is important to note that even a very thin ex. <1 mm and/or short ex. 20 mm MB can cause significant symptoms. MBs can range from a few mm in length to 10 cm or more. The overall prevalence of myocardial bridge is 19%, although its prevalence found by autopsy is much higher (42%).
Robert E. Michler is an American heart surgeon specializing in heart surgery, aortic and mitral valve repair, coronary artery bypass surgery, aneurysm surgery, and management of the failing heart. In 2017, Michler received the Vladimir Borakovsky Prize in Moscow from the Ministry of Health of the Russian Federation for “his personal contributions to the development of cardiovascular surgery”.
Minimally invasive cardiac surgery, encompasses various aspects of cardiac surgical procedures that can be performed with minimally invasive approach either via mini-thoracotomy or mini-sternotomy. MICS CABG or the McGinn technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy approach. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an anterolateral mini-thoracotomy.
Vessel harvesting is a surgical technique that may be used in conjunction with a coronary artery bypass graft (CABG). For patients with coronary artery disease, a physician may recommend a bypass to reroute blood around blocked arteries to restore and improve blood flow and oxygen to the heart. To create the bypass graft, a surgeon will remove or "harvest" healthy blood vessels from another part of the body, often from the patient's leg or arm. This vessel becomes a graft, with one end attaching to a blood source above and the other end below the blocked area, creating a "conduit" channel or new blood flow connection across the heart.
The ZEUS Robotic Surgical System (ZRSS) was a medical robot designed to assist in surgery, originally produced by the American robotics company Computer Motion. Its predecessor, AESOP, was cleared by the Food and Drug Administration in 1994 to assist surgeons in minimally invasive surgery. The ZRSS itself was cleared by the FDA seven years later, in 2001. ZEUS had three robotic arms, which were remotely controlled by the surgeon. The first arm, AESOP, was a voice-activated endoscope, allowing the surgeon to see inside the patient's body. The other two robotic arms mimicked the surgeon's movements to make precise incisions and extractions. ZEUS was discontinued in 2003, following the merger of Computer Motion with its rival Intuitive Surgical; the merged company instead developed the Da Vinci Surgical System.
Dr R Ravi Kumar graduated from Stanley Medical College and obtained the FRCS from Edinburgh. He worked at the Harefield Hospital, UK, under Sir Magdi Yacoub involving himself with adult cardiac surgery including heart and lung transplant and aortic homografts. Dr Ravi Kumar then underwent surgical residency in Boston, MA, United States. Following this he worked with Dr Albert Starr in Portland, Oregon. He pursued his cardiothoracic residency at the University of Texas, South Western Medical Center, Dallas, Texas, U.S. He continued at the same institution as an advanced fellow in Heart & Lung Transplant and is UNOS, certifiable for Heart & Lung Transplant.
Uwe Klima is UAE based professor of surgery and a faculty member at the Hannover Medical School, Germany. He also is the medical and managing director at German Heart Centre, Dubai.
George E. Green is an American cardiac surgeon best known for pioneering and implementing the first surgical procedure of the left coronary artery bypass graft using the internal thoracic artery sutured to the left anterior descending coronary artery to bypass obstruction to the heart circulation in the late 1960s. He applied these techniques in 1968 at New York University Medical Center and in 1970 he was hired to establish St. Luke's Hospital's cardiac surgery program in Manhattan, New York, that by 1982 was seeing approximately 1,800 cases a year, the biggest program in the state. Green has lectured internationally on the topic and has written numerous reports on internal thoracic artery grafting as well as co-authoring, Surgical Revascularization of the Heart: The Internal Thoracic Arteries.
John D. Puskas is an American researcher, author, inventor and cardiovascular surgeon. As of 2022, he is Professor, Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, and chairman, Department of Cardiovascular Surgery at Mount Sinai Morningside, Mount Sinai Beth Israel and Mount Sinai West. He holds 11 U.S. patents and co-founded the International Coronary Congress and the International Society for Coronary Artery Surgery. He is credited by ResearchGate with 330 publications and 15,234 citations and as of 2022 Scopus reports an h-index of 62. Puskas is known for advancing coronary artery bypass (CABG) surgery by refining surgical techniques for all-arterial, off-pump CABG and inventing finer instruments to be used for advanced coronary bypass surgical procedures. He is credited with performing the first totally thoracoscopic bilateral pulmonary vein isolation procedure. He is the co-editor of State of the Art Surgical Coronary Revascularization, the first textbook solely devoted to coronary artery surgery.
Mario F.L. Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHA is an Italian cardiothoracic surgeon who is the Stephen and Suzanne Weiss Professor in Cardiothoracic Surgery (II) and Professor of Clinical Epidemiology and Health Services Research at Weill Cornell Medicine and an attending cardiac surgeon at NewYork-Presbyterian Hospital and Weill Cornell Medical Center. He is an expert in coronary revascularization and clinical trialist. He is known for conducting the PALACS trial, which demonstrated that posterior pericardiotomy at the time of cardiac surgery reduced the incidence of post-operative atrial fibrillation and pericardial effusion.
