Dr. Cynthia Steimle, a cardiovascular surgeon at Sherman Hospital in Elgin, has observed a major improvement in equipment quality and surgical techniques since her career began 16 years ago.
"The concept hasn't changed," Steimle
"We do have better equipment and instruments, better sutures.
But the biggest change involves how we harvest veins to replace the diseased arteries."
Until relatively recently, veins were surgically cut from a patient's legs or arms, leaving long, disfiguring scars, sometimes causing patients to complain more about the pain in their legs than the actual bypass surgery.
"Now, we make small incisions in the patient's leg or arm and use an endoscope to harvest the selected vein," Steimle
"Patients heal much faster and have far less soreness.
Complications that can arise from a patient's weight or diabetes are significantly reduced as well."
In the beginning, cardiovascular surgeons performed "beating heart" surgery, in which the heart continued to pulse while the surgical procedure was taking place.
"You can imagine how hard that was, with the heart jumping around," Steimle
"For most people, stopping the heart gives the best outcome, but in some cases now we are trending more toward a hybrid of the two approaches," says Steimle
"This gives us the best chance of getting really sick patients through high-risk surgery."
Also improved is the tubing used in the heart-lung machine, which connects to the heart to circulate and oxygenate the patient's blood during surgery.
"One tube goes into the right atrium where the veins bring blood back into the heart, and the second goes into the aorta," Steimle
"The tubing materials are much less irritating than they were in the past."
Other advancements have aided in diagnosing and treating heart disease.
For example, ultrasound is now used to assure that the patient has no serious plaque buildup that might break up during the procedure, increasing the risk of stroke.
"But what is really remarkable and seldom given much attention is the change in how we think about bypass surgery," says Steimle
"When you really think about it, we're mostly working with patients in their 70s, 80s and even 90s, who are undergoing major surgeries lasting up to five hours.
Yet the risk of death has dropped to 1 to 2 percent."
points out that cardiovascular surgeons have learned so much, not only about surgery, but also about aftercare, that it's now possible to offer bypass surgery to most older, sicker patients, rather than leaving them to suffer pain and reduced quality of life.
"Results are really remarkable, and many patients can have the chance to feel better," says Steimle