Surgical coronary intervention

If an intervention of the coronary arteries using a catheter is not possible or sensible, surgical coronary revascularization, i.e., restoring blood supply to the heart muscle, is necessary. In this procedure, the constrictions of the coronary arteries are bypassed with the body's own vessels (English: bypass). The OPCAB technique (off-pump coronary artery bypass) is a possible method to perform this on the beating heart without a heart-lung machine. Mostly chest wall arteries are used as bypass material as they ensure long-lasting bypass function. If these are not sufficient, arteries from the arm, rarely from the abdomen, or veins from the legs are used.

In appropriate cases, the so-called MIDCAB procedure (minimally invasive direct coronary bypass) can also be applied. Here, the operation is performed either only through a small incision and a partial opening of the breastbone or through a small lateral access through the ribs without opening the breastbone.