Coronary bypass is by far the most common type of heart surgery, according to the Society of Thoracic Surgeons. Among the 90 percent of United States facilities that report their data to the STS, nearly 170,000 bypass procedures were performed in 2014.
Unfortunately, most Americans find it easier to make an informed decision about cars and refrigerators than about cardiac surgeons. Most people are referred to a heart surgeon by their cardiologist or primary care physician, but may still wish to explore their options in selecting a surgeon for their procedure.
There are three key questions patients need to ask when considering a cardiac surgeon for a coronary artery bypass operation:
Will their heart be stopped during the procedure and their blood circulated through a cardiopulmonary (heart-lung) bypass machine or will it be performed “off pump”?
The heart-lung machine allows the heart to be stopped so the surgeon can operate on a heart that is blood-free and still. During off-pump cardiac surgery, the heart continues to beat normally. Only the surgical surface is immobilized while the rest of the heart keeps pumping and circulating blood to the body.
At The Valley Hospital, more than 75 percent of cardiac surgeries are performed off-pump. The off-pump procedure reduces the risk for blood transfusions and may help reduce the risk of stroke.
What are the chances the patient will need a blood transfusion?
In 2014, more than 80 percent of patients who underwent coronary bypass surgery at Valley had no transfusions at all. Minimizing the use of transfused blood reduces the risk for infection or inflammatory reactions that may be associated with transfusions.
Will the bypass be performed using veins or arteries?
Arterial grafts are superior to venous grafts because they reduce the risk of a repeat operation and result in better outcomes. Specifically, the use of the internal mammary artery is considered a quality indicator for coronary bypass surgery. At Valley, we use both single and bilateral internal mammary arteries for bypass procedures more frequently than the national average.
The bottom line: Patients should seek out an experienced cardiac surgeon and make sure that his or her results are good. The Valley Hospital has been recognized by The Society of Thoracic Surgeons, who has given us its highest rating — 3 stars — for aortic valve surgery, coronary bypass, and a combination of both procedures. Only 1.8 percent of hospitals nationally have achieved these combined awards.
We are also proud to have been selected by the Cleveland Clinic — the No. 1 cardiac center in the country — to be a member of the Cleveland Clinic Cardiovascular Specialty Network. When seeking a cardiac surgeon, patients should also make sure that the entire program has high ratings and rankings.
By Alex Zapolanski, M.D., Director of Cardiac Surgery at The Valley Hospital in Ridgewood, N.J.