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The High-Tech Heart: No Clear Difference Reported in 2 Types of Bypass Surgery

separator 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 conclusions:

  • 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 procedures
  • 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.
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