Every year new advances in medicine help physicians give their patients the care they need with fewer side effects and faster recoveries. In the field of heart surgery, one of the biggest advances in the past twenty years has been off-pump surgery, which allows surgeons to graft new vessels onto the heart without stopping the heart.
Coronary artery disease, or the build-up of blockages in heart vessels, is the cause of heart attacks and a leading cause of death in the country. Prevention of the disease includes eating a diet low in fat and cholesterol, moderate exercise daily and not smoking. Once the blockages occur, however, minimally-invasive treatments such as angioplasty and stenting are required. For patients with multiple areas of limited blood flow, coronary artery bypass surgery may be needed.
This surgery involves sewing arteries and veins onto the heart to channel blood around the blocked areas to re-establish blood flow. In the past, a heart-lung machine would pump a patient’s blood during surgery allowing the surgeon to stop the heart to work on it. Now surgeons can use devices to gently hold the heart still in small areas, allowing them to work on that area of the heart while the rest of the heart beats normally.
Though open heart surgery using a heart-lung machine still has great results, off-pump surgery has been shown to lower the risk of certain complications from the surgery. Patients who are older and have pre-existing medical problems, particularly lung disease and kidney disease, benefit from having off-pump surgery. Some studies have shown a lower risk of heart arrhythmias and a lower need for blood transfusions when the heart-lung machine is not used. Patients also seem to heal faster and return back to normal daily activities when the heart-lung machine is not used.
Not every patient who needs coronary artery bypass surgery is a candidate for off-pump surgery. The decision to have off-pump surgery depends on the location of the blocked vessels, the strength of the heart and the surgeon’s experience with the operation, as not all heart surgeons perform the procedure. Patients who need open heart surgery should be sure to talk to their surgeons at length about the pros and cons of the operation as well as the risks, benefits and alternative options before proceeding with surgery.