The High-Tech Heart: No Clear Difference Reported in 2 Types of Bypass Surgery
Surgeons perform heart bypass operations in one of two
ways. They can stop the patient’s heart from beating and connect the patient to
a heart-lung machine, which pumps blood through the body until the heartbeat is
restored. This is called the “on-pump” technique, and it’s the more traditional
type of bypass surgery.
The other type is called the “beating heart” technique.
Surgeons perform the bypass and allow the heart to beat the entire time. This
surgery is technically more demanding, because it’s more difficult to operate
when the heart is constantly beating.
A report in the journal Circulation comparing the
two types of bypass operations concluded there are advantages and disadvantages
to both operations, but that overall survival rates were the same. Some of the
- Surgeons are able to perform more bypass grafts, if
needed, using the on-pump technique
- Patients who had off-pump bypasses had a greater number
of short-term benefits, such as less blood loss and less need for transfusions
- Hospital stays tended to be shorter for off-pump
- A small number of on-pump patients seem to have memory
and attention deficits
- When surgeons had to change the procedure from the
beating heart technique to the on-pump technique, patients had a greater risk
of organ failure and death
The authors of the report—a team of cardiac surgeons,
cardiologists, anesthesiologists and neurologists—indicated that they believed
that the skill of the surgical team and the quality of the hospital had more to
do with the outcome than whether the surgery was performed on or off the pump.
The American Heart Association; Circulation,
31 May 2005; The New York Times, “Few Differences Seen in 2 Types of Bypasses,” 31 May 2005.