Controversial ’beating heart’ method proves better than standard procedure

Patients needing second-time or “re-do” heart surgery have a new safer alternative. New findings show that an “off-pump” surgical procedure is performed safely and has improved outcomes for patients than traditional methods.

Due to a newly standardized approach and enhanced technology, doctors can perform this controversial surgery and eliminate the damaging effects of using a heart bypass machine. Off-pump surgery, also known as the “beating heart” method, is performed while the heart is still beating without foreign support, such as the heart-lung machine, used in cardiopulmonary bypasses.

99% of the 86 patients undergoing re-do surgery in this study had the procedure initiated off-pump, out of which five were later converted to using a heart-lung machine. There were no deaths of those five patients and 81 procedures were successfully completed without a bypass machine. Of the 6.7% predicted deaths based on past on-pump redo operations, use of the beating heart method in this study resulted in just 2.2% deaths.

Reintroduced in the mid-1990s, off-pump surgery in this study was reviewed to determine “safety, efficacy, and technical challenges in beating heart reoperative CABG (coronary artery bypass grafting).” According to the study, redo surgery is characterized by increased deaths and disease when compared to first-time operations. The Society of Thoracic Surgeons (STS) National Database reports that operative mortality in redo heart surgery for the first six months in 2002 was 5.02%, twice as high as first-time CABG (2.3%).