The Weill Cornell Department of Cardiothoracic Surgery has an extensive history of performing coronary artery bypass surgery, the most commonly performed surgical procedure for treating coronary artery disease. We achieve excellent outcomes: In 2010, the mortality rate among our CABG patients was zero. Our outcomes are consistently among the best in New York State, and routinely exceed the national average.
Coronary artery disease afflicts a large number of Americans every year. This is due to build-up of cholesterol and calcium in the arteries supplying the heart (coronary arteries), leading to blockages and "hardening of the arteries." These blockages prevent enough blood from reaching the heart and if left untreated, can cause a heart attack. Many of these blockages can be fixed with stents. In patients with certain types of blockages, extensive research has shown that coronary artery bypass surgery is a better option. With these blockages, surgery is associated with a lower risk of future heart attacks, less need for additional procedures in the future, less chest pain (angina), and a longer life expectancy.
During CABG surgery, the surgeon takes a blood vessel from the chest, arms, or legs and uses it to route blood around blockages in the coronary arteries in order to restore adequate blood circulation to the heart. For the main bypass, the internal mammary artery is taken from the undersurface of the breastbone and attached to the heart. For additional bypasses, an artery or vein is taken from another area of the body. This can often be done endoscopically so that a large incision in the leg is no longer necessary.
Our surgeons take a modernized approach to coronary bypass surgery to maximize the durability of this operation for you. Research has shown that using arteries instead of veins to perform the bypass improves the durability of the bypass grafts. Many patients are candidates for CABG using multiple arterial grafts. Our surgeons carefully analyze the coronary angiograms and perform ultrasound testing of the arteries in the arms to choose the best option for you, whether that is bilateral internal mammary grafting (BIMA), radial artery grafting or saphenous vein grafting.
We have special expertise in performing CABG in elderly patients (age 80 and older) and in those with co-existing medical conditions. Neither age nor other health conditions will restrict our ability to provide you with the best care to meet your individual needs.
We offer CABG through conventional open-heart and minimally invasive approaches. With the minimally invasive approach, the surgeon makes a small (2-3 inch) incision between the ribs to perform a bypass on the main artery of the heart.
In select cases, coronary artery bypass grafting can be performed without the use of the heart-lung machine. In this "beating heart" (also called off-pump) technique, a small vertical incision is made in the chest, and a mechanical stabilizing device is used to restrict movement of the heart so that the surgeon can perform surgery while the heart is beating. The heart maintains its own rhythm without the assistance of the heart-lung machine.