Due to a newly standardized approach and enhanced technology, doctors can perform this controversial surgery and eliminate the damaging effects of using a heart bypass machine. Off-pump surgery, also known as the "beating heart" method, is performed while the heart is still beating without foreign support, such as the heart-lung machine, used in cardiopulmonary bypasses.
99% of the 86 patients undergoing re-do surgery in this study had the procedure initiated off-pump, out of which five were later converted to using a heart-lung machine. There were no deaths of those five patients and 81 procedures were successfully completed without a bypass machine. Of the 6.7% predicted deaths based on past on-pump redo operations, use of the beating heart method in this study resulted in just 2.2% deaths.
Reintroduced in the mid-1990s, off-pump surgery in this study was reviewed to determine "safety, efficacy, and technical challenges in beating heart reoperative CABG (coronary artery bypass grafting)." According to the study, redo surgery is characterized by increased deaths and disease when compared to first-time operations. The Society of Thoracic Surgeons (STS) National Database reports that operative mortality in redo heart surgery for the first six months in 2002 was 5.02%, twice as high as first-time CABG (2.3%).
This study is published in the Journal of Cardiac Surgery. Media wishing to receive a PDF of this article please contact medicalnews@bos.blackwellpublishing.net
About the Author Dr. Michael Mack received his MD in 1973 from theSt. Louis University and currently practices in Dallas, Texas. Dr. Mack presently sits on numerous editorial boards and committees worldwide including the editorial board for The Annals of Thoracic Surgery and as chairman of the Workforce on Annual Meeting Tech-Con Task Force for The Society of Thoracic Surgeons. He is a reviewer for The Annals of Thoracic Surgery, the Journal of Cardiovascular and Thoracic Surgery, Circulation, and the American Journal of Cardiology. He has authored and co-authored more than 175 peer-reviewed journal articles and over 75 books or book chapters within the field of cardiothoracic surgery. Dr. Mack is available for questions and interviews and can be reached through his assistant Sherry Mullins-Hill at 972-566-4866.
About the Journal of Cardiac Surgery Journal of Cardiac Surgery has over 20-years of history as an important professional resource. Edited by Bernard S. Goldman, MD, editorial coverage includes biologic support, mechanical replacement of thoracic organs, and surgical techniques, and features current material on topics such as xenotransplantation, immunobiology, bridges to transplant and to recovery, and other minimally invasive cardiothoracic procedures.
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Journal of Cardiac Surgery