Overview
Beating heart bypass surgery or off pump coronary artery bypass (OPCAB) is an enhanced option to conventional bypass surgery.
Doing surgery on a beating heart eliminates the need for the heart-lung machine. This may result in fewer side effects.
Benefits
Some of the potential benefits of beating heart surgery include:
- A lower risk of stroke1
- Fewer problems with memory loss and thinking skills2,3,4
- Lower death rate – especially among women and "high risk" patients5
- Less need for transfusion6,7,8
- Reduced injury to the heart9
- Shorter hospital stay10
- Fewer heart rhythm problems7
Long-term Success of OPCAB
The majority of OPCAB surgery patients have improvement or complete relief of their symptoms and remain symptom-free for several years.11 They may recover from surgery more quickly than those who go "on pump" and they may suffer from fewer post-operative complications.7
Risks
Risk of death from the surgery is usually very low. As with any surgery, there are risks involved. The risks are no greater for off-pump heart bypass surgery than for conventional bypass surgery. Risks can include but are not limited to:
- Bleeding
- Infection
- Stroke
- Kidney failure
- Lung complications
- Death
There are many factors that can determine risk. Including:
- Age (older than 70)
- Health at the time of the surgery
- In the case of emergency surgery
- Smoking
- Poor heart muscle function
- Diabetes
- Chronic lung disease
- Chronic kidney failure
Talk to Your Doctor
In the case of cardiac surgery of any type, discuss these risk factors with a doctor to determine the best treatment.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
1
Karamanoukian, H, et al. Decreased incidence of postoperative stroke following off-pump coronary artery bypass. J Am Coll Cardiol. 2002;39:917.
2
Newman, et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001;344(6):295-402.
3
Diegler A, et al. Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation. Ann Thorac Surg. 2000;69:1162-1166.
4
Bhaskar Rhao B, et al. Evidence for improved cerebral function after minimally invasive bypass surgery. J Card Surg. 1998;13:27-31.
5
Arom K, et al. Safety and efficacy of off-pump coronary artery bypass grafting. Ann Thorac Surg. 2000;69:704-710.
6
Puskas JD, et al. Clinical outcomes, angiographic patency, and resource utilisation in 200 consecutive off-pump coronary bypass patients. Ann Thorac Surg. 2001;71:1477-1484.
7
Boyd W, et al. Off-pump surgery decreases postoperative complications and resource utilization in the elderly. Ann Thorac Surg. 1999;68:1490-1494.
8
Ascione R, et al. Beating versus arrested heart revascularization: evaluation of myocardial function in a prospective randomized study. Eur J Cardio-thorac Surg. 1999;15:685-690.
9
Rastan, A J, et al. On pump- beating heart versus off pump coronary artery bypass surgery—evidence of pump induced myocardial injury. Eur J Cardiothorac Surg. 2005; 27:1057-1064.
10
Ascione R, et al. Economic outcome of off-pump coronary artery bypass surgery: a prospective randomized study. Ann Thorac Surg. 1999;68:2237-2242.
11
www.mayoclinic.com: Coronary Bypass Surgery.