Patients Talk

Advances in Bypass Surgery and Vessel Harvesting

Coronary artery bypass grafting (CABG) is a treatment for narrowed or blocked arteries that supply blood to the heart muscle. Advances in bypass surgery now enable some patients to undergo the procedure without the use of the heart-lung machine. This "off pump" surgery can have real benefits for patients, including shorter hospital stay and quicker recovery time. LifeBeat Online talked to Tom Bailey and Kevin Lawler, two men who have experienced the benefits of off-pump—or "beating heart"—bypass surgery.

During bypass surgery, a healthy blood vessel is removed from the leg or arm and used to detour blood around the narrowed or blocked artery in the heart. Tom and Kevin also benefited from advances in the way a healthy blood vessel is removed—or harvested—from the arm or leg.

In traditional harvesting, the doctor makes a long cut down the leg or arm to get the section of blood vessel that is needed. In endoscopic vessel harvesting, the doctor makes one to three small cuts. The vessel is then removed from the small cut. Endoscopic vessel harvesting has been shown to decrease complications and infections as the wound heals.

Tom Bailey

Tom Bailey has a uniquely personal perspective on the advancements in bypass surgery over the past 30 years. He had his first bypass surgery in 1973, when he was 35. His second bypass surgery was in 1988, when he was 50. And he had his third bypass operation in 2003, when he was 65.

"Each operation has been 15 years apart. That means I'll have my fourth one when I'm 80. I'm already looking forward to it!"

Tom has a family history of coronary artery disease. "I was just 35 when my doctor told me I needed to have my first bypass surgery. My brother died of a heart attack in his early thirties. All of my male cousins have either died or had heart surgery." Tom felt especially fatigued before his most recent bypass operation, which he postponed until his wife retired from her job as a nurse. "That way she was able to take care of me after my operation."

His most recent operation was also the first one done "off-pump," without being hooked up to a heart-lung machine. Thirty years ago, when Tom had his first bypass surgery, the operation was in its infancy. "I was in the hospital for almost three weeks back then. I was in a rehab program for at least six months. There was a tremendous amount of trauma associated with the surgery. But at the time it was considered to be leading edge.

"Fifteen years ago I was in the hospital for less than a week, but the recovery period was still very long. This was partly due to the large incisions made to harvest veins, and the related scarring. And I had a lot of pain in my upper chest. That pain was made worse by the coughing required to clear my lungs.

"My most recent surgery had so much less trauma associated with it. As a third-time bypass patient, I'm the kind of patient who's most challenging. Not every surgeon will operate on someone who has already had two bypass operations. I have lots of scar tissue from my earlier operations.

"Endoscopic vein harvesting, or EVH, is also a major breakthrough. The tiny incision made in my thigh meant that I had no pain in my legs afterwards. After my earlier operations I had large incisions that were very painful.

"After off-pump surgery and EVH I was able to start exercising much sooner. I was quite run down before the surgery, so it took some time to rebuild my muscles. But in other respects I felt good after just a few weeks."

A retired chemical engineer who lives in Newark, Delaware, Tom and his wife have two children and three grandchildren who live nearby. He goes for walks and keeps busy doing yard work for himself and for his son and daughter.

He is grateful for a quiet, family-oriented life in a part of the country he finds "so pretty there really is no reason to go anywhere else. I feel very lucky. And after my two previous experiences with bypass surgery, I feel like I was especially lucky this time around."

Kevin Lawler

As a 25-year veteran of the police force in suburban Philadelphia, Kevin Lawler is trained to remain calm during an emergency. Even when the emergency is his own.

He and his wife Karen, a nurse, were watching a funny movie on television one evening in April 2003, when Kevin started having chest pains. "I was laughing so hard, and then I started feeling pains in my chest."

He was taken to the local hospital, where he was given medication to relieve the pain. A heart catheterization the next day revealed blocked arteries, and Kevin was scheduled for coronary artery bypass surgery.

"I was scared when the doctor first told me I would need to have open-heart surgery. But then I found out that he would do a type of surgery called 'off-pump' or 'beating heart' bypass, without hooking me up to a heart-lung machine. That meant my heart would be beating on its own during the whole operation. A guy I work with had been through both on-pump and off-pump operations. He told me that off-pump was definitely the way to go.

"After having the surgery I would recommend off-pump to anyone. Just two weeks later I felt like a million bucks. I've had none of the side effects you can get with on-pump operations.

"And Karen was pretty impressed by the one-inch incision in my thigh, where my vein was harvested. I had a procedure called EVH, or endoscopic vein harvesting, which doesn't require a large incision. As a home health nurse Karen sees a lot of very painful, full-length incisions after bypass operations. And those bigger incisions take so much longer to heal.

Six weeks later Kevin returned to work at the police department, opting for a desk job. He also returned to his second job as an assistant at a funeral home.

When he retires from his police job he and Karen, their two dogs and a parrot plan to travel to the West Coast by recreational vehicle. Kevin is also passionate about a more old-fashioned type of travel. He has sailed six times on the tall ship Rose featured in the movie "Master and Commander." He learned to sail the Rose when it was a training ship in Connecticut.

When he's closer to home the father of two, grandfather of one, stepfather of two and step-grandfather of four, clearly relishes the time he spends with his family. "One of my step-grandchildren was born two days after I came home from the hospital. And my first biological grandchild was born a few months later. I get a little misty-eyed when I think about being able to watch them grow up. "I'm going to get to bounce these grandkids on my knee and play with them in the backyard. I'm in my fifties now, and I'm going to be around for a long time.

"Two weeks after my surgery I went to see my primary-care doctor. When I walked in he asked me when I was going to have my bypass surgery. I told him I'd had it two weeks earlier. He could hardly believe it, because I looked so good. I feel like I really hit a home run with this surgery."

Note: Individual symptoms, situations, and circumstances may vary. Please consult your physician or qualified health provider regarding your condition and appropriate medical treatment. The information provided is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice.

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