Originally created 10/10/01

Bypass operations success rates similar



DALLAS -- Bypass patients whose hearts are allowed to keep beating while they are on the operating table have the same one-month survival rate as those who are put on a heart-lung machine during surgery, a study found.

The Dutch study of 281 patients looked at what are known as "beating-heart," or off-pump, bypass operations.

In traditional bypass surgery, the heart is stopped and the patient is hooked to a machine that keeps blood circulating through the body. However, the machines are frequently blamed for long-lasting mental confusion and memory loss.

In beating-heart operations, the heart keeps on beating, and surgeons use a device called an Octopus to hold the coronary arteries still while they operate.

The study did not look at whether the patients suffered any loss of mental sharpness.

However, one month after the surgery, 93 percent of the beating-heat patients and 94.2 percent of the heart-lung machine patients had survived without suffering a heart attack or a stroke or needing another procedure. Researchers said the difference was statistically insignificant.

Beating-heart patients were able to leave the hospital one day earlier, on average, than those on the heart-lung machine.

The study suggests that "off-pump bypass surgery is safe and yields a short-term cardiac outcome comparable to that of on-pump bypass," said study leader Peter P.T. de Jaegere of the University Medical Center in Utrecht, the Netherlands.

The study was published in Tuesday's issue of the journal Circulation.

In a bypass operation, surgeons take a piece of blood vessel and sew it into place to create a detour around a clog in a heart artery.

The researchers studied patients at three hospitals in the Netherlands. Tests showed that the amount of a cardiac enzyme released by off-pump patients was 41 percent less than that of the on-pump group, indicating the off-pump patients suffered less damage to the heart during surgery.

The researchers found the average cost of the off-pump operation, $3,112, to be slightly lower than that of the on-pump operation, $3,535.

Dr. Bassam M. Khalil of Central Baptist Hospital in Lexington, Ky., estimated that 25 percent of bypasses are or off-pump operations. He said such surgery is more difficult, because the heart is moving. But he said: "There's no doubt, off-pump is the future."

On the Net:

American Heart Association: http://www.americanheart.org