Bypassing blocked arteries near the heart has been a successful surgical procedure since the 1960s. A small number of cardiothoracic surgeons are using a technique that, in appropriate patients, can result in lower risks from side effects of the surgery.
McLeod Cardiothoracic Surgeon Scot Schultz explains the two major types of coronary artery bypass surgeries:
Here are a few points from Dr. Schultz’s video:
- The typical coronary artery bypass graft is pretty similar to the approach back in the nineteen sixties. The traditional operation uses a heart-lung machine, which takes over the function of the patient’s heart and lungs.
- This allows the surgeon to operate on a heart that’s not beating and with no pulsing blood in the area of surgery.
- In the late 1990’s, Beating Heart Surgery became a realistic alternative to conventional bypass surgery but is still performed in only about 18% of bypass patients. In this operation, the patient is not attached to the heart-lung machine. The heart is never stopped during the procedure and continues to beat.
- There are several benefits to the “beating heart” procedure.
- The big impact is in reducing brain injury such as neurocognitive disorders and strokes that are associated with the heart-lung machine. With beating heart bypass, the risk of a stroke is less than half a percent. With the conventional operation, there’s about a 2% risk for stroke.
- The risk of stroke is higher in the elderly population. Hence, beating heart surgery is perhaps better for that age group.
- There’s less need for blood transfusion.
- Beating heart patients are on the ventilator for a shorter period of time.
- The incidence of infection may be lower.
- And the frequency of renal failure or kidney disease following the operation is also less likely with the beating heart procedure.
- The beating heart procedure is more difficult for the surgeon, trying to stitch moving blood vessels that are between one and three millimeters in size. The required precision is one of the reasons more surgeons have not adopted this technique.
Cardiologists generally handle the initial diagnosis and testing and, if surgery is needed, work with Cardiothoracic Surgeons.
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