A Better Approach to Cardiac Bypass Surgery: Less Pain, Less Risk and Less Recovery Time

Learning you need cardiac bypass surgery can be worrisome. Fortunately, Miami Cardiac & Vascular Institute offers a minimally invasive approach to this procedure, eliminating the need to cut open your chest or stop your heart, and greatly reducing pain and recovery time.

Even better, the Institute’s chief of cardiac surgery, Joseph McGinn Jr., M.D., is internationally recognized for pioneering this minimally invasive coronary artery bypass graft surgery.  Known as the McGinn Technique, the innovative surgery is currently performed routinely in only a handful of American hospitals, but is likely to become tomorrow’s standard of care, he says.

“This blows away regular surgery,” Dr. McGinn says. “Eventually, it is going to be part of every surgeon’s repertoire.”

When You Need Bypass Surgery

Coronary artery bypass surgery is a procedure used to treat the narrowing of the arteries that supply oxygen and nutrients to the heart. Cardiologists may recommend bypass surgery if coronary arteries are so narrowed or blocked that you run a high risk of a heart attack.

Joseph McGinn, Jr., M.D., chief of Cardiac Surgery at Miami Cardiac & Vascular Institute.

Research has shown that the minimally invasive approach is just as safe and effective as the traditional approach, which was developed in the 1970s. However, it is much less taxing on patients, requiring only small incisions between the ribs. “You bypass the pain, you bypass the disability, you bypass the big zipper incision to separate the sternum,” Dr. McGinn explains. “Why have your chest cracked open and your heart stopped if you don’t need to? That’s the real question.”

Miami Cardiac & Vascular Institute, part of Baptist Health South Florida, has been at the forefront of innovation since its inception, with a particular emphasis on minimally invasive procedures and providing patients access to tomorrow’s care today. That’s the main reason a surgeon of Dr. McGinn’s caliber was attracted here as he advances the technique and teaches it to cardiac surgeons around the world.

Evolving Science

Since arriving at Miami Cardiac & Vascular Institute two years ago, Dr. McGinn has continued to improve the minimally invasive technique. “You always come up with ways of doing it better,” he explains. “We’ve made a couple of major advances that have made it a little easier for surgeons, a little more reproducible and a little quicker.”

In January, he presented updates to cardiac surgeons from around the world at a meeting of the prestigious Society for Thoracic Surgeons. “What I showed is totally new — we just started doing this technique at Miami Cardiac & Vascular Institute. We are putting a hook under the sternal bone and pulling it up to give us extra room inside, improving access and creating space to do bypasses quicker. It makes a big difference.”

Dr. McGinn is also working on research to support the use of arteries taken from the chest for bypass rather than harvesting veins from a patient’s leg, eliminating a very painful aspect of the traditional bypass surgery. “Patients complain about post-surgical leg pain more than about the chest incisions,” Dr. McGinn says. “With the help of engineers, I am trying to figure out how we can use this all-arterial approach on more and more patients.”

Is The Minimally Invasive Approach For You?

Dr. McGinn, who has done more than 2,000 of these procedures, says that with a few exceptions, most patients are candidates for the minimally invasive approach. In fact, patients often seek him out from other states and countries. “Many of today’s patients are Internet-savvy and they are looking for alternatives to traditional surgery,” he says.

Dr. McGinn notes that patients have the right to seek the care they want, even if their physician initially refers them elsewhere. Because most cardiac bypass surgeries are still done the traditional way, patients must actively pursue the minimally invasive route if that is what they desire.

“Most patients don’t know about this; they just go where their doctor tells them to go,” Dr. McGinn says. “In South Florida, there are many people getting their chest cracked open unnecessarily every day.”

How It Works

The traditional approach to bypass surgery can be grueling for patients, who often endure considerable pain and a recovery time of three months or longer.

After witnessing how difficult this can be on patients, Dr. McGinn devised a new approach to spare them some of the discomfort, blood loss and risk. Instead of opening up the chest, Dr. McGinn accesses the clogged arteries through a small, two- to three-inch incision between the ribs. He then uses a graft of healthy blood vessel to create a new route, or bypass, so blood can get around the blockage and reach the heart.

“The concept behind this surgery is we don’t break any bone and we don’t cut any muscles, so the structural integrity of the chest remains intact,” he explains.

Most traditional bypass surgeries put patients on a heart-lung machine so the heart can be stopped during the procedure, but Dr. McGinn avoids this step. Instead he uses specially engineered instruments so he can operate on the beating heart. “When you stop the heart, there is always a chance of damaging other organs, damaging blood vessels, damaging the lungs, the kidneys, and even the brain.”

What You Need To Know

Older patients and those with co-morbidities should understand their options when they are advised to get bypass surgery, Dr. McGinn says. “There is almost no reason anymore to crack open someone’s chest for this,” Dr. McGinn says. “That adds a whole other level to their recovery.”

Patients are often surprised to learn they can have this complex procedure with a minimally invasive approach, even if they require multiple bypasses. Dr. McGinn notes he routinely does triple and quadruple bypasses using this method.

“This field is evolving just like every other field of medicine because our skills and equipment are expanding,” he says. “My ultimate goal is for every surgeon to be able to do what I am doing.”

In addition to the good results Dr. McGinn gets with the minimally invasive approach, he is particularly gratified by what it means to the quality of life of patients.

“The traditional surgery requires three months to recover. Patients are told they won’t be able to go back to work, and for a lot of people that is unacceptable,” he says. “I let them go back to work a week after discharge. They can lift, they can drive, they can golf — they can do whatever they want to do without fear of damaging anything.”