Treating Heart Disease With Coronary Bypass Surgery at Jupiter Medical Center

Coronary artery bypass grafting (CABG) is a procedure used to treat heart disease, specifically blockages of the blood vessels that supply the heart muscle with blood and oxygen. During a CABG surgery, your surgeon takes a blood vessel from another part of the body, and attaches it (“grafts” it) above and below the blockage in the heart. This “bypasses” the blockage, improving blood flow.

CABG is a major, but common surgery, with a long record for safety and effectiveness. After coronary bypass surgery at Jupiter Medical Center, patients are cared for in our specialized cardiovascular intensive care unit. In our dedicated unit, patients are monitored 24/7 by specialists who are trained in providing intensive care for people recovering from heart surgery.

The Jupiter Medical Center Cardiac Surgery Team

The cardiac surgery team at Jupiter Medical Center’s Heart & Vascular Institute is led by Dr. Arthur Katz, a cardiac surgeon with over 25 years of experience performing coronary artery bypass grafting. Dr. Katz is recognized as a leading expert in “off-pump” coronary artery bypass (OPCAB). During “off-pump” CABG, the heart continues to beat on its own throughout the surgery.

We take a team approach to CABG, bringing together our region’s leading surgeons, cardiologists, anesthesiologists and nurses to take care of you before, during and after your surgery and cardiac rehabilitation.

When is CABG Recommended?

Coronary artery bypass grafting may be recommended for coronary artery disease, aka coronary atherosclerosis, which occurs when the blood vessels that provide blood and oxygen to the heart become damaged or blocked. The blockages and hardening of the arteries are due to a build up of fat, calcium, cholesterol and other materials. These materials form a plaque on the inside of the coronary arteries, causing obstruction of the vessel. This narrowing or restriction of blood flow raises the risk of clot formation within the artery, along with symptoms such as angina (chest pain), or heart attack.

Some blockages can be treated using angioplasty, a cardiac catheterization procedure in which a tiny balloon in inserted into the vessel and expanded at the site of the blockage to widen the narrowed artery. Usually, the physician will leave behind a stent at the site of the blockage to help prop it open and decrease the risk of it narrowing again.

But depending on where the blockage is, how severe it is and how many blockages are found, CABG may be needed, in addition to or instead of angioplasty.

What Happens During Coronary Bypass Surgery?

During CABG, a surgical team will take one or more blood vessels from another part of your body and connect it to the blocked artery in your heart. CABG surgery may involve one or several arteries.

• Double bypass – Two repairs
• Triple bypass – Three repairs
• Quadruple bypass – Four repairs
• Quintuple bypass – Five repairs, the most complex bypass surgery that includes all five of the major arteries that supply the heart with blood

CABG may be a scheduled surgery, or if may be done in an emergency situation.

• Cardiologists may recommend CABG if you:
• Have had a heart attack, or are at high risk of having a heart attack.
• Are experiencing ongoing, significant chest pain (angina) or shortness of breath because of blocked or narrowed coronary arteries.
• Have previously undergone angioplasty with or without stenting, and the artery has narrowed again.

What are the Signs of Coronary Artery Disease?

The gradual buildup of plaque can cause signs and symptoms including angina (chest pain), shortness of breath, nausea, sweating and vomiting. Atypical symptoms, especially in women, can include severe fatigue, mid-abdominal discomfort, arm or jaw pain.

Angina is often described as pressure or tightness in the chest. The pain can be triggered by physical exertion, or psychological or emotional stress. The discomfort may go away soon after you’ve stopped the activity that brought it on.

Shortness of breath or extreme fatigue associated with coronary artery disease occurs because the heart can’t pump enough blood to meet the body’s needs. Heart attacks can occur when there is a severe or sudden blockage. More than 800,000 men and women suffer from a heart attack each year in the United States.

Offering Patients Off-Pump CABG

During CABG, surgeons reroute blood flow around the blocked artery. The traditional way of performing this surgery is temporarily stopping the heart from beating. While the heart is stopped, a heart-lung machine takes over the function of the heart.

“Off-pump” coronary artery bypass grafting, also known as “beating heart” bypass surgery, was developed later. Off-pump coronary artery bypass (OPCAB) is performed while the heart is still beating, and does not require the use of a heart-lung machine. During OPBCAB, the surgeon uses a stabilization device to stop just the area of the heart where the bypass will be attached, or grafted. Meanwhile the rest of the heart continues to beat.

Jupiter Medical Center’s Cardiovascular Intensive Care Unit

After coronary artery bypass grafting, patients recover in our dedicated cardiovascular intensive care unit. This specialized ICU provides 24/7 monitoring by cardiologists and nurses with training in providing intensive, personalized care for heart and vascular patients after surgery. We strive to make sure our patients are comfortable, and that we keep families and loved ones updated.

Cardiac Rehabilitation

After coronary artery bypass surgery, it takes several weeks of recovery before you can expect to return to normal activities, including work and leisure activities.

Jupiter Medical Center’s cardiac rehabilitation program provides individualized support to help you regain your strength, stamina, flexibility and mobility in the weeks after surgery. Your personalized cardiac rehab plan will include a progressive program of supervised exercise therapy. The goal is to help you feel confident in returning home and returning to the activities you enjoy, to increase your physical fitness after surgery, and to make sure you have the tools to manage your heart health over the long-term.

Taking Care of Your Heart After CABG

After your recovery from coronary artery bypass surgery, you may feel a lot better. But it’s important to remember that the surgery doesn’t fix the underlying cause of the heart disease that led to the blockages in the first place.

After coronary artery bypass grafting, you may need to take medications to treat high blood pressure, irregular heart rhythms, blood thinners to prevent blood clots, or statins to lower cholesterol levels.

Lifestyle changes, such as exercise, healthy eating, lowering stress and anxiety, quitting smoking and losing weight, can also help you maintain your heart health, and keep you feeling great.