Cardiovascular News

Beating Heart Breakthrough

In traditional bypass surgery, the heart is stopped. Blood is pumped through a heart-lung machine outside the body. The machine pumps oxygen and nutrients through the blood. Studies have shown that placing patients on a heart-lung machine may increase the risk of brain injury or stroke.

In a new type of bypass surgery, the heart is left pumping, which can reduce complications. The newer surgery is called beating heart bypass surgery.

Beating Heart Bypass

During beating heart bypass surgery, a special instrument keeps small parts of the heart from moving. This allows the doctor to operate while the heart is still pumping. In certain patients, this type of surgery can result in quicker recovery, shorter hospital stays, less blood loss, and better survival rates. There is also less chance for heart, kidney, liver, or brain damage.

A new study led by Jeffrey D. Lee, MD, associate professor of surgery at the University of Hawaii, confirms the benefits of this technique for the brain. In a traditional bypass, less blood reaches the brain. For a beating heart surgery patient, Dr. Lee notes, "There is no change in blood flow to the brain." This difference may explain the higher stroke rate for traditional bypass surgery patients. Dr. Lee says, "These findings give scientific evidence to what we always suspected. Beating heart surgery may be safer for patients from a brain perspective!"

Currently, about 375,000 bypasses are performed each year in the United States. About a quarter of them use the beating heart technique. When compared with traditional bypass surgery, beating heart bypass procedures:

Cut blood transfusion rates by almost half¹
Shorten the hospital stay after surgery by 40%¹
And after 3 months, reduce brain injury after surgery by 90%²

In the opinion of Dr. Lee, "Patients now and in the future should strongly consider beating heart surgery."

Murkin JM; Boyd WD; Ganapathy S; Adams SJ; Peterson RC; Beating heart surgery: why expect less central nervous system morbidity? Annals of Thoracic Surgery, 1999 Oct, 68(4): 1498-501
Puskas JD; Wright CE; Ronson RS; Brown WM; Gott JP; Guyton RA. Clinical Outcomes and Angiographic Patency in 125 Consecutive Off-Pump Coronary Bypass Patients. Heart Surgery Forum 1999; 2(3): 216-221

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