Overview
When the arteries cannot supply enough blood to the heart, the doctor may recommend coronary artery bypass graft (CABG) surgery. OOne is the most commonly performed cardiac surgery procedure worldwide3,4.
Approximately every 10 minutes, someone has beating heart or "off-pump" bypass surgery1. Beating heart bypass surgery is — in simple terms — bypass surgery that is performed on the heart while it is beating. The heart will not be stopped during surgery. There will not be a need for a heart-lung machine. The heart and lungs will continue to perform during the surgery3,4.
Surgeons use a tissue stabilisation system to immobilise the area of the heart where they need to work.
Beating heart bypass surgery is also called Off Pump Coronary Artery Bypass Surgery (OPCAB). Both OPCAB and conventional on-pump surgery restore blood flow to the heart.
What Happens During Beating Heart Bypass Surgery?
First, the surgeon removes a section of a healthy vein or artery from an area of the body. This is called a graft. The surgeon attaches one end of the graft to an area of the heart above the blockage in the artery. The other end is attached to an area of the coronary artery below the blockage. Once the graft is attached, blood flow to the heart is restored.
The challenge in beating heart CABG surgery is that it can be difficult to suture or "sew" on a beating heart. The surgeon must use a "stabilisation" system to keep the heart steady.
The stabilisation system consists of a heart positioner and a tissue stabiliser. The heart positioner guides and holds the heart in a position that provides the best access to the blocked arteries. The tissue stabiliser holds a small area of the heart still while a surgeon works on it.
Conventional On Pump Coronary Artery Bypass Surgery
More than 70%2 of all bypass surgeries are performed on a stopped heart. Unlike beating heart surgery, during conventional on pump heart bypass, medication is used to stop the heart.
A heart-lung machine takes over the function of the heart and lungs during the surgery.The heart-lung machine is also called a cardiopulmonary bypass machine. It has a pump to function as the heart and a membrane oxygenator to function as the lungs.
A patient is placed on cardiopulmonary bypass during conventional open heart surgery (heart lung machine), this keeps oxygen rich blood circulating throughout the body so the surgeon can perform on a still heart.
Heart-Lung Machine
This mechanical "heart and lungs" keeps oxygen rich blood circulating throughout the body. The heart-lung machine collects the blood. Carbon dioxide and other waste products are removed. The oxygenator adds oxygen, and the oxygenator's heat exchanger warms (or cools) the blood. The blood is gently circulated back through the body. This process is called perfusion. The person who operates the heart-lung machine is the perfusionist.
Stopping The Heart
The heart will usually be stopped for about 30-90 minutes of the 3-6 hour surgery. The heart-lung machine makes it possible for the surgeon to work on a still heart.
1
Data on file, Medtronic, Inc.
2
The Advisory Board: Outlook for Cardiac Surgery, 2006
3
Department of Cardiac Surgery, CHU UCL Namur, Yvoir, Belgium
4
Department of Cardiovascular Surgery, Mount Sinai St. Luke’s Hospital, New York, NY, USA
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.