Going the Distance: Finding the Right Surgeon Can Make Cardiac Bypass Less Traumatic

Distance was not a consideration for Timothy Wenn, M.D., when he learned that he needed triple bypass surgery for clogged arteries to his heart. Although he lives in North Carolina, he was determined to come to Baptist Health Miami Cardiac & Vascular Institute.

Dr. Wenn wanted minimally invasive surgery, and he knew exactly who he wanted to perform it: Joseph McGinn Jr., M.D., the Institute’s chief of cardiac surgery.

Dr. McGinn has earned international renown for pioneering an innovative approach to minimally invasive coronary artery bypass graft surgery. His procedure eliminates the need to cut open the patient’s chest or stop the heart, greatly reducing pain and recovery time. Known as the McGinn Technique, the surgery is currently performed routinely in only a handful of American hospitals.

 “It was worth traveling from North Carolina to Miami,” says Dr. Wenn, who underwent surgery in July and completely recovered in less than two weeks. “I actively sought him out because I knew that he had developed this minimal invasive technique and that he had been doing it for several years.”

(Watch video: Hear from patient Timothy Wenn, M.D., and Joseph McGinn, Jr., M.D., chief of cardiac surgery at Miami Cardiac & Vascular Institute. Video by George Carvalho.)

Signs of Trouble

Dr. Wenn, who lives in Charlotte, is triple board-certified in emergency medicine, internal medicine and urgent care. About six years ago, he had a stent inserted into one of his cardiac arteries to keep blood flowing to his heart. A very active outdoorsman, he has focused on his diet and exercise to fight further heart disease.

Earlier this year, however, he noticed that he was getting tired very quickly while on his regular runs. Concerned, his cardiologist suggested he undergo catherization, which revealed three of his four cardiac arteries were blocked.

“I was fortunate to have some mild symptoms, recognize them and get early evaluation rather than wait for a heart attack,” Dr. Wenn says. “The last thing you want to do is ever actually have a heart attack, which causes heart muscle damage.”

Advised to get triple bypass surgery, Dr. Wenn began seeking a specialist who could do it in a minimally invasive fashion. No one in his area had the skill and experience, he says. Several colleagues suggested Dr. McGinn, who has taught this technique to physicians around the world.

After researching Dr. McGinn’s success and watching a video of him performing the procedure, Dr. Wenn knew he found the right surgeon. His wife, a registered nurse, accompanied him to Miami and stayed at the Hilton adjacent to Baptist Hospital. “It’s nice that there’s a hotel only 600 feet away from the hospital,” Dr. Wenn says. “That added a very nice touch to the whole experience.”

The minimally invasive surgery with Dr. McGinn turned out exactly as he’d hoped. “As predicted, the pain and discomfort were minimal to none,” Dr. Wenn says. He was back to work almost immediately, and soon was able to resume all his favorite pastimes.

“It has given me my life back in the sense that I can continue what I’ve been enjoying for so long — trail bike riding, hiking, camping, physical workouts… I’m at full, 100 percent capacity.”

At 71, he doesn’t anticipate slowing down anytime soon. “I plan on making this decade as active and full as possible,” he says. In fact, he has visions of even bigger adventures.

For the past three years, he has done tandem parachute jumps with an instructor to celebrate his birthday. He says he’s now ready to take the heart-pounding next step. “I should learn how to parachute by myself and do it more frequently,” he says. “That’s that’s my next goal.”

He’s grateful that Dr. McGinn has made that possible for him. “He gets as many stars as anybody can get,” Dr. Wenn says. “Dr. McGinn’s team of nurse practitioners and the hospitalists, the nurses, even the aides were all wonderful and supportive.”

Who Needs 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.

About 90 percent of the 250,000 bypass procedures performed each year in the United States use the traditional approach with a large zipper incision in the chest and a heart-lung machine that takes over pumping the patient’s blood so the heart can be stopped.

Surgeons then use a graft of healthy blood vessel taken from elsewhere in the body — usually the chest, leg or arm — to create a new route, or bypass, so blood can get around the blockage and reach the heart. Recovery can take three months or more.

Research has shown that a less invasive approach, such as Dr. McGinn’s technique, is just as safe and effective as the traditional approach, which was developed in the 1970s. Even better, it is much less traumatic 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.”

How It Works

After witnessing how difficult the traditional approach can be on patients, Dr. McGinn devised his technique 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.

“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.”

Who Can Benefit

Dr. McGinn, who has done more than 2,000 of these minimally invasive beating-heart procedures, says that with a few exceptions, most patients are candidates for this approach. He has continued to advance the technique since arriving at Miami Cardiac & Vascular Institute in 2020.

“A lot of patients are told that they can’t have more than one vessel done through a minimally invasive approach. This is completely not true,” Dr. McGinn says. “We do this every day here at Miami Cardiac & Vascular Institute. We operate on patients who need double, triple, quadruple bypasses all the time.”

In most cases, patients are able to leave the hospital in about three days. “I ask them to wait about five to seven days after discharge, and then they can literally resume their normal life,” Dr. McGinn says. “That means they can drive, they can lift, they can swim, they can shower — they can do anything they normally do.”

Dr. McGinn says he appreciates the trust and confidence his patients place in him, particularly when those patients are fellow medical professionals who have sought him out, like Dr. Wenn.

“I’ve had the unique opportunity of operating on physicians — people from all over the world, all over the globe,” he says. “They’ve come in from all different countries, from almost every state in the union. It is a very humbling and very flattering experience.”