Doctors in the United States have achieved a global medical first by performing a coronary artery bypass without opening the patient’s chest, marking a major breakthrough in heart surgery and offering new hope to high-risk patients who cannot undergo conventional procedures.
The pioneering operation was carried out by specialists from the US National Institutes of Health (NIH) and Emory School of Medicine, who successfully rerouted blood around a blocked heart artery using a minimally invasive, catheter-based technique.
Traditionally, coronary artery bypass surgery requires surgeons to open the chest, stop the heart and place the patient on a heart-lung machine.
While effective, the procedure is physically demanding, carries significant risks and often involves weeks or months of recovery.
In contrast, the new approach avoids open-heart surgery entirely.
Using thin tubes known as catheters, doctors accessed the heart through blood vessels in the patient’s leg.
They then created a new pathway for blood flow around the blocked artery, allowing the heart to continue beating throughout the procedure.
The patient was a 67-year-old man who required replacement of a previously implanted aortic valve.
His heart anatomy made standard surgery extremely risky because the opening of his left coronary artery was positioned dangerously close to the valve.
Existing minimally invasive options were also unsuitable, prompting the medical team to develop an entirely new technique.
The method, called ventriculo-coronary transcatheter outward navigation and re-entry (VECTOR), reroutes blood through the body’s natural vessels.
Doctors guide catheters from the leg to the heart, create a new channel from the aorta to the coronary artery, and insert a stent to support the vessel walls. A bypass graft then restores safe and reliable blood flow.
Six months after the procedure, follow-up tests showed no evidence of blocked arteries, marking VECTOR’s first successful use in a human patient.
“This project moved rapidly from concept to human use, and seeing it succeed is incredibly rewarding,” said Dr Christopher Bruce, an interventional cardiologist at NIH and Emory School of Medicine. “It shows the power of collaboration and innovation in tackling the most challenging heart conditions.”
Researchers believe the technique could benefit patients with complex coronary disease who are too frail for open-heart surgery or cannot be treated with stents, potentially expanding access to life-saving care.
Why this breakthrough matters
Open-heart bypass surgery carries risks such as infection, bleeding, stroke and prolonged recovery. Even in well-resourced health systems, in-hospital mortality ranges from 1 to 3 per cent, with higher risks for older or critically ill patients.
The new minimally invasive bypass reduces trauma by working through natural blood vessels, usually via the leg.
Recovery is faster, pain is reduced and the risk of major complications is lower, making the procedure suitable for patients who would otherwise be deemed inoperable.
Globally, more than one million open-heart surgeries, including bypasses, are performed each year, yet millions more patients lack access due to cost, infrastructure and specialist shortages.
In Kenya, cardiovascular disease is an escalating public health challenge, accounting for about one in four hospital admissions and a significant share of deaths.
An estimated 5,000 children with congenital heart disease require surgery annually, but only 120 to 150 congenital open-heart operations are performed locally each year. Many patients are forced to seek treatment abroad at prohibitive cost.
Experts say innovations like VECTOR could eventually reduce hospital stays, lower costs and broaden access to advanced heart care—particularly in settings where surgical capacity is limited.
If adopted more widely, the technique could redefine how complex heart disease is treated, offering safer and less invasive options for patients once considered beyond help.