The surgery of the coronary vessels is put into place (established) during the last decades, internationally, as a method of treating coronary artery disease, along with other therapeutical strategies such as angioplasty (balloon) or/and stent implantation. Today, it corresponds to a 60 – 70% of the total range of cardiac surgery and it includes, except of the conventional aortocoronary (using venous grafts) bypasses, a series of other modern innovative therapeutic selections. The range of our clinics includes all the sectors of modern coronary vessel surgery.
Conventional aortocoronary bypass (Coronary artery bypass surgery) with heart-lung bypass machine.
Off-Pump Coronary Artery Bypass (OPCAB).
Minimally Invasive Direct Coronary Artery Bypass (MIDCAB).
Full arterial re-perfusion of myocardium.
Hybrid procedures (combination of bypass procedure and cardiological intervention with cardiac catheterization).
Conventional aortocoronary bypass using vein grafts (ACVB) and cardiopulmonary bypass device
This procedure is realized with general anesthesia and it consists one of the standard procedures of our clinic, in the coronary bypass surgery. After opening the sternum, cardiac arrest is provoked with the administration of a special cardioplegic solution, while the heart-lung bypass machine maintains the circulation and the patient’s supply with oxygen. After the placement of the grafts, the better perfused heart retrieves again its function. As grafts, the left internal thoracic artery is used and also the patient’s veins from the internal side of the thigh and the calf. In our clinic, the vein grafts are created endoscopically or using minimally interventional techniques, so as to achieve the minimization of infections and healing disorders and also a good esthetic result.
ΟPCAB (Off-Pump Coronary Artery Bypass)
It concerns a surgical technique during which the use of cardiopulmonary bypass device is not needed. With the help of stabilizing instruments, the target vessels are stabilized and then, they are bypassed with vein or arterial grafts. Avoiding the use of heart-lung bypass machine is related with a significantly lower risk for stroke and it is preferred for patients with recent infarct or coexisting disorders of pulmonary and/or renal function.
MIDCAB (Minimally Invasive Direct Coronary Artery Bypass)
This technique is a variation of OPCAB technique and it is applied in patients with coronary disease localized in the anterior cardiac wall. As graft, the internal thoracic artery is usually used. The surgical access is realized through a small anterolateral section on the left side, 6 – 8 cm approximately in length. The use of a heart-lung bypass machine is not necessary also here.
Full arterial re-perfusion of myocardium
In this technique, exclusively arterial grafts are used. In contrast with the veins, the wall of the arteries has a stronger muscular layer. In this way, they can adopt better in the existing flow conditions and they remain passable for a longer period of time. As arterial grafts, both the internal thoracic arteries and the radial artery are used.
The hybrid procedures consist of combinative surgical bypass and cardiac catheterization procedures. They are performed in close cooperation with the Department of Cardiology. The patients with indications for hybrid interventions are presented in the scientific council, where the procedure that will be followed is discussed.