Benefits and Risks – Beating Heart Bypass Surgery Coronary Artery Disease (CAD)

Overview

Beating heart bypass surgery or off pump coronary artery bypass (OPCAB) is an enhanced option to conventional bypass surgery. 

Doing surgery on a beating heart eliminates the need for the heart-lung machine. This may result in fewer side effects.

Benefits

Some of the potential benefits of beating heart surgery include:

  • A lower risk of stroke1
  • Fewer problems with memory loss and thinking skills2,3,4
  • Lower death rate – especially among women and "high risk" patients5
  • Less need for transfusion6,7,8
  • Reduced injury to the heart9
  • Shorter hospital stay10
  • Fewer heart rhythm problems7

Long-term Success of OPCAB

The majority of OPCAB surgery patients have improvement or complete relief of their symptoms and remain symptom-free for several years.11 They may recover from surgery more quickly than those who go "on pump" and they may suffer from fewer post-operative complications.7

Risks

Risk of death from the surgery is usually very low. As with any surgery, there are risks involved. The risks are no greater for off-pump heart bypass surgery than for conventional bypass surgery. Risks can include but are not limited to:

  • Bleeding
  • Infection
  • Stroke
  • Kidney failure
  • Lung complications
  • Death

There are many factors that can determine risk. Including:

  • Age (older than 70)
  • Health at the time of the surgery
  • In the case of emergency surgery
  • Smoking
  • Poor heart muscle function
  • Diabetes
  • Chronic lung disease
  • Chronic kidney failure

Talk to Your Doctor

In the case of cardiac surgery of any type, discuss these risk factors with a doctor to determine the best treatment.

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

1

Karamanoukian, H, et al. Decreased incidence of postoperative stroke following off-pump coronary artery bypass. J Am Coll Cardiol. 2002;39:917.

2

Newman, et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001;344(6):295-402.

3

Diegler A, et al. Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation. Ann Thorac Surg. 2000;69:1162-1166.

4

Bhaskar Rhao B, et al. Evidence for improved cerebral function after minimally invasive bypass surgery. J Card Surg. 1998;13:27-31.

5

Arom K, et al. Safety and efficacy of off-pump coronary artery bypass grafting. Ann Thorac Surg. 2000;69:704-710.

6

Puskas JD, et al. Clinical outcomes, angiographic patency, and resource utilisation in 200 consecutive off-pump coronary bypass patients. Ann Thorac Surg. 2001;71:1477-1484.

7

Boyd W, et al. Off-pump surgery decreases postoperative complications and resource utilization in the elderly. Ann Thorac Surg. 1999;68:1490-1494.

8

Ascione R, et al. Beating versus arrested heart revascularization: evaluation of myocardial function in a prospective randomized study. Eur J Cardio-thorac Surg. 1999;15:685-690.

9

Rastan, A J, et al. On pump- beating heart versus off pump coronary artery bypass surgery—evidence of pump induced myocardial injury. Eur J Cardiothorac Surg. 2005; 27:1057-1064.

10

Ascione R, et al. Economic outcome of off-pump coronary artery bypass surgery: a prospective randomized study. Ann Thorac Surg. 1999;68:2237-2242.

11

www.mayoclinic.com: Coronary Bypass Surgery.