"Keeping the Beat" During Bypass Surgery
Doctors Say Stopping the Heart During Surgery Not Always Necessary

Most traditional bypass surgeries involve connecting a patient to a heart-lung machine which substitutes for the patient’s own heart and lungs and allows surgeons to stop the heart from beating while they perform delicate surgery on its blood vessels. But, some health care experts say that heart-lung machines place patients at risk for potentially fatal complications such as stroke, abnormal rhythms, lung problems, and fluid retention.

Drs. Donald Gibson and Miguel Gomez, cardiovascular surgeons at Memorial Hermann Memorial City Hospital, are demonstrating that patients whose hearts are allowed to continue beating during bypass surgery recover more quickly and better than those who undergo a traditional bypass.

Drs. Gibson and Gomez, have successfully performed more than 600 "off-pump" or "beating-heart" bypass surgeries since 1999. That represents almost 97 percent of their bypass surgeries – the highest percentage of off-pump bypasses being performed in the Houston area. Nationally, only 10 to 15 percent of all bypass surgeries are performed off-pump.

With the off-pump technique, Drs. Gibson and Gomez use a device called an Octopus that immobilizes a small section of the heart while the rest of the heart beats normally, supplying blood to the body. Suction cups attach to the heart muscle on either side of the artery on which the surgeons operate.

An estimated 500,000 Americans undergo heart bypass surgery each year. Studies find that while more than 95 percent of the cases are successful, there remain serious side effects and occasional deaths, many resulting not from the surgery itself, but from the heart-lung machine.

"We take an aggressive approach to treating our patients," said Dr. Gomez. "We consider every patient referred to us a candidate for off-pump bypass."

Clinical studies conducted around the world and in the Hermann Memorial City team’s own two-year retrospective study show enormous benefits for patients using the off-pump procedure.

"They recover faster, spend less time on the ventilator, experience fewer complications, have lower mortality and stroke rates and a shorter postoperative length of stay," said Dr. Gomez. "I checked on one off-pump bypass patient four hours after operating on him and he was sitting up in bed reading the newspaper. That’s incredible."

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©2006 Texas Medical Center

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