Traditional versus New Heart Bypass Surgery Techniques

There is great amount of confusion not only amongst patients but also amongst general physicians and referring doctors regarding the benefits of beating heart surgery. Beating heart surgery in various parts of the world has taken by storm especially in underdeveloped countries, mostly promoted by surgeons under-pressure to counter and perform against much publicised, hyped and also practiced “angioplasties”  by cardiologists.

Following passage is an attempt to throw some light on some startling facts in the back drop of recent researches comparing traditional vs. beating heart surgery.
Surgery to bypass blocked heart arteries has traditionally been done using a heart-lung machine. This machine circulates blood throughout the body while the heart is stopped to permit bypass surgery. It was thought that these heart-lung machines were the cause of
or contributed to certain complications — such as stroke, memory loss or trouble thinking clearly — occasionally observed after surgery.

In recent years, techniques have been developed so that bypass surgery can sometimes be done without a heart-lung machine, while the heart is still beating. The theory was that this would improve results by reducing complications associated with the heart-lung machine.

Not so, according to a study published in the The New England Journal of Medicine. The study randomised more than 2,203 men into two groups that received bypass surgery either with or without heart-lung machines. One year later, about 10 percent of those who had bypass surgery without a heart-lung machine had died, had a heart attack or needed another surgery to open a blocked artery. These outcomes occurred in only about 7 percent of those who had surgery using the machines. There was no difference in cognitive function between the two groups.

A probable explanation is that it’s more technically challenging to sew bypass arteries onto a beating heart. This resulted in a small number of planned bypasses never being completed.

Specialists at Mayo Clinic say the study clearly shows that bypassing all blocked arteries must be the goal of any bypass procedure, regardless of the chosen approach. Beyond that, the results remain controversial because the study population was all male and generally younger and healthier than the typical person receiving bypass surgery.

Other studies have shown that women and older, sicker adults may benefit from off-pump bypass. In addition, varying surgeon and anaesthesiologist skills may have altered results. However, the fact remains that in the hands of extremely skilled surgeons and anaesthesiologists, some class of patients people may benefit from bypass surgery done without a heart-lung machine also called as Beating Heart Surgery.