Our Summary

The study is looking at two different types of heart bypass surgery, one where the heart is still beating during the operation (on-pump beating-heart surgery) and one where the heart is stopped (off-pump surgery). The researchers wanted to see which method had better outcomes for patients with poor heart function, specifically those with a left ventricular ejection fraction (EF) of 35% or less.

Over 200 patients with low EF who had heart bypass surgery between 2010 and 2014 were analyzed. Some had the on-pump beating-heart surgery and some had the off-pump surgery. The researchers then compared the patients’ health outcomes after the surgery.

The results showed that there was no significant difference in the number of deaths between the two groups. However, the patients who had the on-pump beating-heart surgery showed a larger improvement in their heart function compared to those who had the off-pump surgery. They also received more grafts and had more fluid drained in the first 24 hours after surgery, but this didn’t lead to worse survival rates or more serious health problems.

In conclusion, the study suggests that the on-pump beating-heart surgery might be a good option for patients with poor heart function.

FAQs

  1. What are the two types of heart bypass surgery being studied?
  2. What were the health outcomes for patients who had the on-pump beating-heart surgery compared to those who had the off-pump surgery?
  3. Based on the study’s findings, which type of heart bypass surgery might be a better option for patients with poor heart function?

Doctor’s Tip

However, it is important to discuss with your doctor which type of surgery is best for your individual case. It is also important to follow your doctor’s post-operative instructions closely, including taking medications as prescribed, attending follow-up appointments, and making necessary lifestyle changes to improve your heart health. Remember to listen to your body and report any concerning symptoms to your healthcare provider immediately.

Suitable For

Patients with poor heart function, specifically those with a left ventricular ejection fraction (EF) of 35% or less, are typically recommended heart bypass surgery. These patients may have conditions such as coronary artery disease, heart failure, or other cardiovascular issues that necessitate bypass surgery to improve blood flow to the heart. The study mentioned above specifically looked at patients with low EF to determine the best surgical method for this population.

Timeline

Before heart bypass surgery, a patient typically undergoes various tests and evaluations to determine the severity of their heart condition and whether surgery is necessary. This may include a physical exam, blood tests, imaging tests (such as an echocardiogram or angiogram), and possibly a stress test.

Once the decision is made to proceed with heart bypass surgery, the patient will be informed about the procedure and what to expect before, during, and after the surgery. They may need to make certain lifestyle changes, such as quitting smoking or losing weight, to improve their chances of a successful outcome.

After the surgery, the patient will be closely monitored in the intensive care unit (ICU) for a period of time to ensure that they are stable and recovering well. They will likely experience some pain and discomfort, which can be managed with medication. Physical therapy may be recommended to help with mobility and recovery.

Over time, the patient will gradually regain their strength and stamina, with the goal of returning to their normal daily activities. It is important for patients to follow their doctor’s recommendations for post-operative care, including taking medication as prescribed, attending follow-up appointments, and making any necessary lifestyle changes to improve their heart health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about heart bypass surgery include:

  1. What are the different types of heart bypass surgery available to me?
  2. What are the potential risks and benefits of on-pump beating-heart surgery versus off-pump surgery for someone with my specific heart condition?
  3. How will my left ventricular ejection fraction (EF) of 35% or less affect my eligibility for each type of surgery?
  4. What outcomes can I expect after surgery in terms of heart function improvement and overall health?
  5. How many grafts will be performed during the surgery and how does this impact the success of the procedure?
  6. What is the recovery process like for each type of surgery, and how long can I expect to be in the hospital?
  7. Are there any long-term considerations or lifestyle changes I should be aware of following heart bypass surgery?
  8. How will my medical history and other health conditions impact the decision between on-pump beating-heart surgery and off-pump surgery?
  9. Are there any alternative treatment options I should consider before deciding on heart bypass surgery?
  10. What is the success rate and experience of the surgical team with each type of surgery?

Reference

Authors: Shen JQ, Ji Q, Ding WJ, Xia LM, Song K, Wei L, Sun YX, Wang CS. Journal: Zhonghua Wai Ke Za Zhi. 2018 Apr 1;56(4):294-298. doi: 10.3760/cma.j.issn.0529-5815.2018.E010. PMID: 29562416