Christopher  L. La Mendola, MD FACS FACC

Blockages in the coronary arteries (the arteries that supply blood to the muscle of the heart) are the cause of most heart attacks and are one of the leading causes of death in the United States.  Each year nearly  five hundred thousand people die of coronary artery disease (CAD).

CAD has many causes including smoking, diabetes mellitus, hypertension and high cholesterol.  In some cases, it may have a genetic component.

Initially, your physician will try to treat your CAD with lifestyle modification and medication.  In some cases, more aggressive treatment is indicated and you may need an angioplasty and placement of a stent to open a clogged artery.  Often, however, the arteries cannot be safely opened with a balloon and so, the most appropriate treatment for your disease will be Coronary Artery Bypass Grafting (CABG). 

CABG is a procedure that  makes no attempt to open the diseased section of the blocked artery, but instead uses a vein or artery from elsewhere in the body to detour around or "bypass" the diseased part of the blood vessel.  The vein is most often harvested from the inner portion of the leg using a special dissecting endoscope; only a few tiny incisions are made, avoiding the more painful, older technique of "open" harvest.   The Internal Mammary Artery (IMA)  is harvested from just under the breastbone, and, because of its very special qualities, it is used to bypass the most important artery on the heart, the Left Anterior Descending Artery. 

Often, the procedure can be performed without placing you on the heart-lung machine; a technique we call "Off-Pump Bypass" or OPCAB.  Although both "On-Pump" and "Off-Pump" procedures have their proponents, OPCAB may offer the advantage of minimizing complications.  Many surgeons believe that the heart-lung machine may play a role in cognitive deficits after heart surgery, and so, by avoiding the pump, the risk of memory loss and other neurologic  complications is lessened. 

Dr. La Mendola was one of the first surgeons in the United States  to use this technique on a regular basis and to date, has performed more than 1500 OPCAB procedures, making him one of the most experienced "Off-Pump" surgeons in the country. 

The operation generally takes about three or four hours to perform, and usually you can expect to stay in the hospital for between four and six days.  In the hands of an experienced surgeon the risk of the procedure is usually quite low.  Be sure to ask your surgeon about the risks and benefits associated with  CABG as well as the "Off-Pump"  alternative, and feel free to ask as many questions as you need to make an informed decision. 

Dr. La Mendola understands that the prospect of Open-Heart Surgery can be terrifying to a patient,  and so he will do everything possible to answer your questions and provide the empathy and compassion needed to ease your anxiety.