‘Beating Heart’ Bypass Not Better?
Similar Mental, Cardiac Results Seen in ‘Beating Heart’ and Traditional Bypass Surgery Study
WebMD News Archive
Feb. 21, 2007 -- "Beating heart" bypass surgery may not trump
traditional bypass surgery for low-risk patients, a new study shows.
In traditional bypass surgery, doctors stop the patients' heart during
bypass surgery and hook the patient up to a heart-lung bypass machine during
But during "beating heart" bypass (also called "off-pump"
bypass), doctors operate on the patient's beating heart, without using a
Heart bypass is done when coronary arteries, which supply blood to heart
muscle, are blocked.
During heart bypass, surgeons take a blood vessel from the patient's chest,
legs, or arms and graft it onto the heart to bypass the coronary blockage.
Past studies have suggested that traditional bypass surgery might boost the
odds of mental decline. Those findings had raised interest in beating heart
Both procedures are major surgery, and certain risk factors may rule out
beating heart bypass for some patients.
The new study comes from Dutch doctors including Diederik van Dijk, MD, PhD,
of the anesthesiology department of University Medical Center Utrecht in
Utrecht, the Netherlands.
They randomly assigned 281 low-risk bypass patients to get beating heart
bypass or traditional bypass. The patients were 61 years old, on average.
Before surgery, the patients took tests of mental skills including
attention, memory, and manual dexterity.
Five years after surgery, 260 of the patients repeated the mental skills
test. Half of the patients in both groups showed a 20% decline in their mental
skills test scores.
Those declines weren't necessarily due to the bypass surgeries. Simply
getting older might have been responsible, the doctors note.
The study also shows that a similar percentage of patients in both groups --
30 patients in the beating heart bypass group (21%) and 25 patients in the
traditional bypass group (18%) -- had a heart attack, stroke, heart-related
death, or more heart surgery during the five-year follow-up period.
The use of beating heart bypass instead of traditional bypass "had no
effect on cognitive or cardiac outcome five years after the procedure" in
these low-risk patients, the researchers conclude.
The study appears in The Journal of the American Medical