Our Summary

This study compared the early outcomes of two types of heart bypass surgeries: on-pump and off-pump. Both surgeries were done while the heart was still beating, without stopping the heart or blocking the main artery.

The study included 736 patients who had their first heart bypass surgery from 2011 to 2018. They were divided into two groups: those who had the surgery with a heart-lung machine (on-pump group) and those who had it without the machine (off-pump group).

The patients in both groups were similar in terms of their general health and characteristics. The results showed that patients in the on-pump group had more bypasses, stayed in the hospital longer, had a lower red blood cell count after surgery, and needed more blood transfusions compared to the off-pump group.

The rates of death and complications after surgery were similar in both groups, except for a heart rhythm problem called atrial fibrillation. This problem was more common in the on-pump group.

The study concluded that the off-pump surgery might be better than the on-pump surgery because patients stayed in the hospital for a shorter time, needed fewer blood transfusions, and had a lower chance of developing atrial fibrillation.

However, more studies with larger groups of patients are needed to confirm these findings.

FAQs

  1. What are the two types of heart bypass surgeries discussed in this study?
  2. What were the key differences discovered between the on-pump and off-pump surgeries?
  3. Are more studies required to confirm the findings of this study comparing on-pump and off-pump heart bypass surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about heart bypass surgery is to discuss with their healthcare provider the option of off-pump surgery, as it may have potential benefits such as shorter hospital stay, fewer blood transfusions, and lower risk of atrial fibrillation. It is important to have an open and informed discussion with your doctor to determine the best approach for your specific situation.

Suitable For

Patients who are typically recommended for heart bypass surgery are those with severe coronary artery disease, which is a condition where the coronary arteries become narrowed or blocked, reducing blood flow to the heart muscle. This can lead to chest pain (angina), shortness of breath, and an increased risk of heart attack.

Patients who have not responded well to other treatments such as medication, lifestyle changes, or less invasive procedures like angioplasty with stenting may be recommended for heart bypass surgery. Additionally, patients with multiple blockages in their coronary arteries or those with more complex coronary artery disease may also be candidates for bypass surgery.

It is important for patients to discuss their individual case with their healthcare provider to determine if heart bypass surgery is the best treatment option for them.

Timeline

Before heart bypass surgery:

  1. Patient undergoes various tests and evaluations to determine the need for surgery, such as angiogram, stress test, and blood work.
  2. Patient meets with their surgeon and anesthesiologist to discuss the procedure and risks involved.
  3. Patient may need to make lifestyle changes, such as quitting smoking or losing weight, in preparation for surgery.
  4. Patient is admitted to the hospital on the day of surgery and prepared for the procedure.

After heart bypass surgery:

  1. Patient is closely monitored in the intensive care unit immediately after surgery.
  2. Patient may stay in the hospital for several days to recover and receive post-operative care.
  3. Patient will be prescribed medications to manage pain, prevent infection, and control blood pressure.
  4. Patient will undergo rehabilitation and physical therapy to regain strength and mobility.
  5. Patient will have follow-up appointments with their surgeon and cardiologist to monitor their progress and adjust their treatment plan as needed.

What to Ask Your Doctor

  1. What are the benefits and risks of on-pump versus off-pump heart bypass surgery?
  2. How will my recovery differ between the two types of surgeries?
  3. Are there any long-term differences in outcomes between on-pump and off-pump heart bypass surgery?
  4. How experienced is the surgical team in performing both types of heart bypass surgeries?
  5. Are there any specific factors in my medical history that would make one type of surgery more suitable for me than the other?
  6. What is the likelihood of needing blood transfusions during or after surgery with each type of procedure?
  7. How will the risk of developing atrial fibrillation be managed in each type of surgery?
  8. Are there any specific lifestyle changes or precautions I should take after either type of surgery?
  9. What are the potential costs associated with each type of surgery, including hospital stay and follow-up care?
  10. Are there any ongoing research studies or clinical trials related to heart bypass surgery that I should consider participating in?

Reference

Authors: Velioglu Y, Isik M. Journal: Thorac Cardiovasc Surg. 2019 Oct;67(7):546-553. doi: 10.1055/s-0039-1679923. Epub 2019 Mar 5. PMID: 30836396