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Home Expertise Bypass surgery
The procedure

Bypass surgery
with beating hearts

The coronary bypass surgery in Tangier, performed with the heart beating, without stopping the heart or cardiopulmonary bypass (heart-lung machine). A coronary artery disease surgery adapted to each patient, especially to fragile patients.

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Sinus rhythm82BPM
Normal frequency90BPM
Duration3 – 4 h
Hospitalization4 – 6 days
AnaesthesiaGeneral

Coronary Bridge with beating hearts
in Tangier

A bypass treats coronary artery disease, meaning the narrowing of the arteries that feed the heart, a process often driven by high blood pressure, diabetes, smoking or cholesterol. The idea is simple: rather than forcing a way through the blockage, the blocked artery is bypassed with a graft, a healthy vessel taken from the chest (the mammary artery), the arm or the leg (the saphenous vein), so the heart muscle gets the blood it needs. When it is done off-pump, without stopping the heart or using the heart-lung machine, certain complications can be reduced in patients who are suitable for it, and particularly in the most fragile. The choice between off-pump and the conventional technique is never automatic: it depends on the anatomy of your arteries and on your general condition. In every case Dr Tber's goal stays the same, a complete revascularisation that relieves angina, planned around your situation.

Main indications

Coronary disease with multiple narrowing of the arteries of the heart Stroke of the common trunk or of several coronary arteries Chest angina (chest pain) limiting daily life Fragile or high-risk patients Heavily calcified aorta (aortic atheroma) making cardiopulmonary bypass difficult A history such as kidney failure, where we try to limit use of the heart-lung machine

Benefits for the patient

Without cardiopulmonary bypass (heart-lung machine) Can reduce some complications linked to the heart-lung machine, especially in frail patients Recovery that can be faster in patients who are suitable for it The goal of a complete revascularization, adapted to each patient A technique that is particularly useful in frail patients, or where the aorta is calcified

Your journey

Step by step

Consultation & review

A full cardiac assessment and pre-operative tests, including the coronary angiogram that maps which arteries need grafting.

Preparation

Choice between off-pump bypass and conventional bypass, planned on a case-by-case basis, with clear patient information.

Intervention

Performing the bypasses in the operating theatre, with a beating heart thanks to a stabilizer, without stopping the heart or resorting to cardiopulmonary bypass.

Recovery & Tracking

Close monitoring, then cardiac rehabilitation for a gradual, supervised return to normal life.

Questions common

You're wondering...
What are the symptoms of coronary heart disease?
Most often pain or tightness in the chest (angina), breathlessness on exertion, or unusual tiredness. Severe chest pain, lasting or coming with sweating, nausea or breathlessness at rest, is an emergency: call the emergency services straight away. Short of an emergency, symptoms brought on by exertion warrant a cardiology consultation and an assessment of the coronary arteries without delay.
How does a bypass take place and where does the graft come from?
The surgeon takes a healthy vessel, most often the internal mammary artery in the chest, sometimes a vein from the leg (the saphenous vein) or an artery from the arm. This graft is attached so as to go around the blocked artery and restore the blood supply to the heart.
Bridge or stent (angioplasty)?
Stent usually treats limited endovascular damage, while bypass is often preferred in the case of multiple arteries or common trunk, especially in diabetic patients. Choice is made with the cardiologist and surgeon depending on your anatomy and general condition.
What difference does it make with a classic bypass?
With a beating heart, the heart is not stopped and cardiopulmonary bypass is avoided, which can reduce some complications, especially in fragile patients or calcified aorta. Both techniques give good results; the choice is individualized, always with the objective of complete revascularization.
How many bypasses can be made?
Several grafts can be done during the same operation. How many depends on the narrowed arteries found on the coronary angiogram, the aim being complete revascularisation.
How long before you resume normal activity?
Getting back to normal is gradual and differs from one patient to the next. Most patients pick their activities back up over a few weeks, alongside a cardiac rehabilitation programme, guided by their surgeon.

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