Bypass procedures have been performed without transfusion. Some patients, such as Jehovah's Witnesses, are restricted from using another person's blood. Studies have shown that bypass procedures can be performed "bloodlessly," although these operations have had a higher rate of mortality.
What is minimally invasive bypass surgery?
Minimally invasive coronary artery bypass surgery (MIDCAB) involves a significantly smaller incision – only three inches – instead of splitting your sternum with a six- to eight-inch incision.
An artery that supplies blood to chest muscles is grafted to the left anterior descending artery (an important artery located close to the chest wall). Your heart continues to beat during the surgery, instead of being attached to a heart-lung machine. You may be given a drug to reduce your heartbeat.
Surgeons can also use a slightly different approach by making small incisions in your chest and viewing the surgery on video monitors. For this procedure, called port-access coronary bypass surgery, your heart is attached to a heart-lung machine.
Doctors are also exploring the use of robotics and telecommunications to perform minimally invasive surgeries, or to provide assistance to fellow surgeons, at remote locations.
The number of minimally invasive coronary bypass surgeries is rising, and now represents about 10 to 20 percent of all bypass operations performed annually. Compared to a traditional bypass surgery, minimally invasive bypass surgery is cheaper, shorter and less painful, requires fewer blood transfusions and reduces your recovery time. Hospital stays for MIDCAB patients can be three to four days, instead of five to six days for a traditional bypass.
However, this type of surgery is only for certain patients with one or two blocked arteries, and the long-term results have not been determined.
What are the risks?
The current success rate for bypass surgery is 95 to 98 percent, meaning that between 2 and 5 percent of all patients have complications, including death. The survival rate has improved over time.