Overview
Dr. Ayubi is experienced in performing both minimally invasive and open vascular procedures, focusing on restoring circulation, relieving symptoms, and improving long-term outcomes with a patient-centered approach.
Common Causes
Coronary artery disease develops when cholesterol plaque narrows or blocks the arteries that supply the heart. Contributing factors include diabetes, hypertension, smoking, high cholesterol, family history, and aging. Severe disease may require bypass rather than stenting alone.
Signs & Symptoms
- Chest pain or pressure (angina)
- Breathlessness on exertion
- Fatigue during routine activity
- Pain radiating to the arm, jaw, or back
- Reduced exercise capacity
- Symptoms of heart attack in acute presentations
When to Consult a Specialist
- Persistent or worsening angina despite medicines
- Significant multivessel coronary disease on angiography
- Left main or proximal LAD disease
- Diabetes with extensive coronary narrowing
- Need for durable long-term revascularization
Diagnosis
- Clinical evaluation and risk-factor assessment
- ECG and stress testing when appropriate
- Echocardiography to assess heart function
- Coronary angiography to map blocked vessels
- CT or additional imaging for surgical planning
Treatment Options
- Lifestyle and medical therapy for coronary disease
- Percutaneous intervention in selected lesions
- CABG with arterial conduits including RIMA-LIMA
- Hybrid strategies in carefully chosen cases
- Long-term secondary prevention after surgery
Procedure Information
During RIMA-LIMA bypass, both internal mammary arteries are prepared and connected beyond blocked coronary segments. The approach prioritizes arterial grafts for lasting blood flow, with intraoperative assessment to confirm graft quality and complete revascularization whenever feasible.
Benefits & Possible Risks
Benefits
- Superior long-term arterial graft durability
- Improved blood supply to critical heart territories
- Better protection against recurrent ischemia
- Reduced early re-intervention risk in suitable patients
- Strong option for younger or high-need patients
Possible Risks
Possible risks include bleeding, infection, arrhythmia, wound healing issues, graft occlusion, stroke, or heart-related complications. Bilateral mammary artery use requires careful patient selection, especially in diabetes or when sternal healing risk is higher.
Recovery & Follow-Up
- Close monitoring in the early post-operative period
- Breathing exercises and progressive mobilization
- Medications for graft protection and heart health
- Cardiac rehabilitation when medically cleared
- Regular follow-up to optimize risk factors