Sunnybrook performs minimally invasive bypass surgery


Sunnybrook’s Schulich Heart Centre became the first centre in Toronto to perform minimally invasive, beating-heart bypass surgery to fix clogged arteries and improve blood flow to the heart.

Both conventional bypass surgery and minimally invasive coronary artery bypass grafting restore blood flow to the heart when there is a buildup of plaque inside the blood vessels. The advantage of using a minimally invasive technique rather than the traditional approach is that it allows the surgeon to work on a beating heart through a small chest incision (small thoracotomy) without having to split the breastbone and place patients on a heart-and-lung machine while surgeons work on the stopped heart.

“Offering a minimally invasive alternative to traditional bypass surgery will have extraordinary benefits for our patients,” says Dr. Fuad Moussa, cardiac surgeon at Sunnybrook’s Schulich Heart Centre. “While we have been performing conventional bypass surgery successfully for many years, the new techniques we are now introducing at Sunnybrook minimize operative risks and patient trauma associated with opening up the chest and stopping the heart. This means patients can often return home after only a few days and resume many normal activities within a couple of weeks rather than a couple of months.”

Every year in Ontario, approximately 7,000 people with coronary artery disease benefit from having bypass surgery. Unfortunately, there are some cases where patients with two or three blocked arteries would benefit from surgical intervention but are not well enough to withstand conventional bypass surgery.

“In the past, we would have to treat those patients with drugs alone, which is not ideal,” says Dr. Moussa, who is also a lecturer in the Department of Surgery at the University of Toronto. “Now, using a technique called hybrid revascularization, we are performing minimally invasive beating heart bypass on the most important coronary artery down the front of the heart and inserting stents into the other vessels. This will give more people access to potentially life-saving surgery.”

During traditional bypass surgery, the surgeon makes a long incision to completely split the sternum (sternotomy) and access the heart. Patients are then placed on a heart and lung machine which acts as a substitute for their own and allows surgeons to work on a stopped heart. People who undergo this surgery generally recover in about six-to-eight weeks. Alternatively, with a small thoracotomy, beating heart approach, the surgeon can perform the operation through a tiny incision under the left nipple (four or five centimeters wide) while the heart continues to beat. This technique lowers the risk of complications such as stroke, lung problems and kidney problems which are associated with the use of a heart-and-lung machine. It also means patients have reduced pain and less need for postoperative pain medication, smaller scars, a shorter stay in the hospital and a faster recovery.

Sunnybrook is one of only a few health sciences centres in Canada currently offering this surgical alternative to traditional bypass surgery.

About Sunnybrook Health Sciences Centre:

Sunnybrook Health Sciences Centre is inventing the future of health care for the one million patients the hospital cares for each year through the dedication of its more than 10,000 staff and volunteers. An internationally recognized leader in research and education and a full affiliation with the University of Toronto distinguishes Sunnybrook as one of Canada’s premier academic health sciences centres. Sunnybrook specializes in caring for Canada’s war veterans, high-risk pregnancies, critically-ill newborns, adults and the elderly, and treating and preventing cancer, cardiovascular disease, neurological disorders, orthopaedic and arthritic conditions and traumatic injuries.