Bouncing Back From Bypass

NASHVILLE, Tenn. Mick Foster couldn't even go for a walk with his girlfriend without worrying about having another heart attack.

"My life expectancy, especially with the way my family is, would probably have been early 50s," Foster told Ivanhoe.

By 40, he had survived two heart attacks and his chest pains returned. His choices: bypass surgery or live with a ticking time bomb in his chest.

"I could never get past the idea of chest open, people's hands inside there playing around," Foster said.

Doctors presented another option -- minimally invasive direct coronary artery bypass or MIDCAB.

"It's radically different than conventional bypass surgery," Stephen Ball, M.D., a cardiothoracic surgeon at Vanderbilt Medical Center in Nashville, Tenn., told Ivanhoe.

Instead of cutting open the entire chest, surgeons make a small incision on the left side of the rib cage. They use the mammary artery to reroute blood to the heart. Suction cups stabilize the heart as surgeons sew the bypass graft while the heart is still beating. At Vanderbilt University it's now being used for multi-bypass surgery.

"My hope would be that almost all of the bypass surgery can be done with this minimally invasive approach," Dr. Ball said.

A traditional bypass means a ten- to twelve-inch incision, the patient's heart is controlled by a machine during surgery and recovery takes six to eight weeks. In MIDCAB the incision is three to five inches, the heart beats on its own and recovery takes about two weeks.

"I could never have done this about two, three years ago," Foster said. "I can breathe now. I can talk now."

After surgery, Foster felt like a new man and he no longer fears what the future holds.

"Now I'm waiting to be 75," he said. "If I get to 75 I'm happy … as long as I get my 401K!"

Only a small number of hospitals will use the minimally invasive approach for multi-vessel bypass. There is a lower infection rate with the MIDCAB surgery and it's about 25-percent less expensive than traditional bypass surgery.

Craig Boener, Vanderbilt Medical Center Public Relations


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