Archived Research: "Beating heart surgery" When patients undergo a coronary bypass operation, they are generally put on what cardiologists call "the pump," which serves as an artificial heart while doctors graft a blood vessel (or blood vessels in double, triple or quadruple bypasses) around the blockage(s). Not surprisingly, there is a great deal of risk and trauma associated with this procedure in which the patient's heart is actually off-line and not beating for several hours. Post-operative lung, brain, and kidney problems are common. Recently, doctors have begun using another, less invasive, method: coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG), or more colloquially, "beating heart surgery." Here, surgeons work directly on the heart without having to break the breastbone to open the chest cavity. A team of scientists from Colorado and North Carolina recently used a large national database to compare traditional bypass and beating heart surgeries. Of the 118,000 bypass procedures done in more than 100 qualified cardiac care facilities in 1998 and 1999, about 10% or 12,000 used the beating heart method. Lower death and serious complication rates and shorter lengths of stay were associated with the less invasive method. After adjusting for the baseline risk of the patients receiving either operation, the beating heart patients were 23% less likely to die and 31% less likely to have a major complication in the first 48 hours after surgery. These gains persisted through 30 days, as well. In an article describing the research in the Annals of Thoracic Surgery, researchers wrote that off-pump surgery may prove "superior to conventional [bypass] in appropriately selected patients, operated on in experienced centers." Further research will look at longer-term outcomes and additional variables. A randomized controlled trial involving 197 individuals published in the Journal of the American Medical Association in April 2004 shows that in this randomized single-surgeon trial among unselected patients with angiographic follow-up, off-pump coronary artery bypass achieved similar results in the hospital and at one year. In addition, patient health-related quality of life at 30 days and one year were similar. The procedure appears to be both durable and cost-effective.   Content on Infoaging is constantly reviewed and updated by leading researchers specializing in the biology of aging and the diseases of aging. For a list of our content experts, click here.