“Off-Pump” Surgical Approach Questioned By New Study

November 17th, 2009

I was just reading the New York Times when I came across a very interesting study about the use of “off-pump” techniques for heart surgery.

The study, just published in the New England Journal of Medicine, suggests that use of heart-lung machines may actually provide enhanced surgical outcomes (inclusive of pumphead) when compared to beating heart procedures.

The highlights of the study, which evaluated 2,203 patients that were randomly assigned to have bypass surgery on-pump or off-pump, were:

One year after surgery, patients who had had off-pump surgery had poorer outcomes.
Off-pump patients were more likely to have needed a repeat operation.
Patient that did not have the heart-lung machine used were more likely to have a heart attack or die.
Off-pump patients were no less likely to have had strokes or difficulty thinking (cognitive problems following surgery).

Dr. Eric Peterson, a Duke cardiologist who wrote an editorial accompanying the paper, stated, “This is a big one… It’s a good study and the fact that it did not find superiority [for off-pump procedures] was key.” Dr. Peterson added that he, like many cardiologists, expected off-pump procedures to be superior.

So you know, bypass surgery is one of the most common operations in the world. Today, as many as 20 percent of bypasses in the U.S. are being done off-pump. That said, this new study could affect a lot of procedures.

The study also suggests that patients who had their surgery “off-pump” did have fewer blood transfusions but spent slightly longer time in the operating room.

Also, the study indicated that there were no significant differences between the two patient groups specific to (i) the time patients spent in intensive care after surgery, (ii) how long patients were on a ventilator and (iii) the length of patient hospital stay.

Pretty interesting study, right?

Keep on tickin!

About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient's Guide To Heart Valve Surgery. This unique book integrates clinical research with the personal experiences of 135 former patients to help future patients and their caregivers better understand the problems, the opportunities and the realities of heart valve surgery. To learn more about Adam and his heart valve surgery book, click here.