Beating Heart Bypass (Off-pump Bypass)

Coronary artery bypass grafting (CABG), often referred to as bypass surgery, is used to treat arteries that feed heart muscle which are blocked by fatty plaques. The surgery involves the rerouting of blood flow around the blocked heart vessels by sewing or grafting clean vessels above and below the blockages. In traditional bypass surgery, the patient's heart is stopped, and its function is taken over by a heart-lung machine. In this way, the surgeon can make the repairs on a motionless heart. When the grafting or repairs are complete, the heart is restarted.

Traditional CABG has provided excellent results for patients. The new grafts often stay patent or clear for 10 to 15 years. There are, however complications associated with CABG, especially in elderly patients or those with many other associated medical problems. Therefore surgeons are always looking for ways to improve their surgical procedures in order to provide more options to patients.

Surgeons consider the patient being on the heart-lung machine to be the most "invasive" component of bypass surgery. Circulating the blood through the heart-lung machine may sometimes cause bleeding complications or effect the kidneys or other organs. Recently it has been found that this type of surgery can be conducted without using the heart lung machine. It can be done safely in patients as long as a tiny portion of the heart, where the repair needs to take place, can be stabilized and quite still. The surgeon can work on the repairs while the rest of the heart beats freely. This procedure has been perfected and is now referred to as "off pump" or beating heart bypass. In most all other ways, the surgery is similar to traditional bypass in that the incision is the same and the new vessel is joined to the blocked artery in the same way. But the fact that the heart is not stopped has many advantages for the patient. Usually, less anesthesia is required because the operation is usually shorter. There is less need for blood transfusions and the hospital stay is often shorter. But most importantly, patients seem to develop fewer complications.

It should be noted that there are patients that are not appropriate for this approach due to factors such as significant heart rhythm abnormalities or the location on the heart of the diseased vessels. You must discuss your options carefully with your physician.

This new procedure is now being performed at BAPTIST HEALTH Medical Center-Little Rock and BAPTIST HEALTH Medical Center-North Little Rock.