Off-Pump Bypass Safe for High-Risk Patients

This may cause lung insufficiency, bleeding, kidney insufficiency, or stroke in high-risk patients. The on-pump procedure also minimizes pulsatile blood flow. The absence of normal heart movement is correlated with a high incidence of renal failure in patients with renal insufficiency. In addition, because the on-pump operation requires the aorta to be clamped, it can further compromise a calcified aorta.

Since 2000, Dr. John C. Chen, M.D., and his surgical team have performed 191 off-pump artery bypass operations on high-risk patients. For 97 patients who underwent the procedure in 2002, the expected mortality was 7.68%, but the observed mortality was only 4.17%. In 2003, the outcome was even better. The expected mortality for 54 patients in off-pump procedures was 7.85%, while the observed mortality was only 1.85%.

Among new tools that have improved the surgery is an apical suction device placed on the apex of the heart to hold it steady during surgery and a new stabilizing device that is placed on the coronary artery to hold it relatively steady. "The artery is not completely still, but it is still enough so experienced surgeons can do an anastomosis with good results,” reported Dr. Chen, who is a professor at the University of Hawaii and chief of cardiothoracic surgery at Kaiser Permanente, Honolulu (Hawaii, USA). Dr. Chen reported the study's findings.