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Closed Bypass Through the Ribs (Minimally Invasive, Small Incision Bypass)

Coronary artery bypass surgery is performed to restore blood flow to the heart when the coronary arteries, which supply blood to the heart, become blocked or narrowed. Healthy arteries and veins taken from different parts of the body are used to bypass the blocked arteries. In this method, the sternum is not cut; instead, small incisions are made under the armpit or below the breast to access the area between the ribs for the bypass procedure. Closed bypass surgery can be performed with the heart stopped or with the heart still beating. The duration of the surgery depends on the number of arteries to be bypassed and ranges from 2 to 4 hours. Your cardiovascular surgeon will decide which method is suitable for you and inform you accordingly.

This method involves making 6-8 centimeter incisions under the armpit or below the breast. Any surgical intervention that can be done with open bypass can also be performed with the closed method.

Bypass surgery, whether performed through open or closed methods, carries risks inherent to the procedure itself. These include:
  • Heart attack
  • Infection
  • Bleeding
  • Kidney and lung problems
  • Blood clots
  • Death
Ozaki Prosedürü
 
In closed bypass surgery, the surgical procedure is the same as in open-heart surgery, but the use of different incisions offers several advantages to patients:
  • Less bleeding
  • Lower risk of infection
  • Faster wound healing
  • Quicker adaptation to normal life
  • Milder psychological impact of the illness
  • No need to lie flat on the back for two months
  • Ability to get in and out of bed without assistance
  • Ability to drive one’s own vehicle in a short time (patients who undergo closed bypass surgery can usually drive their own vehicles within 15 days, whereas those who have open surgery are typically not permitted to drive for at least 1.5 months)
  • No issues with bone healing
  • Small and less visible scars
Almost every patient with coronary artery disease can be treated with the closed method. After surgery, there is usually a 1-day stay in the intensive care unit (ICU). By the end of the first day in the ICU, the patient is made to walk and then moved to regular monitoring in a hospital ward. During this time, the drains placed during surgery are monitored and typically removed by the second day.

When the patient is transferred to the ward:

  • They can get in and out of bed without assistance.
  • They can attend to their toilet needs independently.
  • They are monitored in the ward for an additional 4-5 days.

Before discharge:

  • The patient receives a prescription and instructions for required exercises.
  • A follow-up appointment is scheduled for one week after discharge.

Follow-up care:

  • The patient may drive themselves to the follow-up appointment.
  • During this first follow-up, the surgical wounds are checked, stitches are removed, a chest X-ray and blood tests are reviewed, and medications are adjusted.
  • The next follow-up appointment is scheduled for one month later.
Aort Cerrahisi