Our Summary

This study is a large, multi-center trial taking place over a year, involving 336 patients who are scheduled for a specific type of heart surgery called coronary artery bypass grafting (CABG). During this procedure, the patients’ body temperature is usually lowered (a process called hypothermic cardiopulmonary bypass or CPB) to protect the heart. However, this cooling can increase the risk of bleeding and other problems.

The researchers will divide the patients into two groups. One group will have a slightly cooler body temperature (32-33 degrees Celsius) during surgery, while the other group will maintain a normal body temperature (35-36 degrees). The main goal of the study is to see which group has less serious bleeding during and after surgery.

Other things the researchers will look at include how well the patients’ blood clots, signs of inflammation, death rates in the hospital, other complications related to surgery, and how long patients stay in the intensive care unit and the hospital.

The results of this study could help doctors figure out the best body temperature to aim for during this type of heart surgery to minimize risks. The trial was registered in China in September 2023.

FAQs

  1. What is the main purpose of this clinical trial involving coronary artery bypass grafting (CABG)?
  2. What are the primary and secondary endpoints of this trial?
  3. What are the potential risks associated with hypothermic cardiopulmonary bypass during CABG?

Doctor’s Tip

A helpful tip a doctor might tell a patient about heart bypass surgery is to follow their post-operative care instructions carefully, including taking medications as prescribed, attending follow-up appointments, and maintaining a healthy lifestyle with regular exercise and a balanced diet. It is also important to report any unusual symptoms or signs of infection to their healthcare provider promptly.

Suitable For

Patients who are typically recommended for heart bypass surgery are those with severe coronary artery disease that cannot be adequately treated with medications or less invasive procedures such as angioplasty. These patients may have symptoms such as chest pain (angina) or shortness of breath, or they may have already experienced a heart attack. The decision to recommend bypass surgery is usually made by a cardiologist or cardiac surgeon after a thorough evaluation of the patient’s condition.

Timeline

Before heart bypass surgery:

  • Patient undergoes diagnostic tests such as coronary angiography to determine the extent of blockages in the coronary arteries.
  • Patient may undergo lifestyle changes, medication management, and other treatments to manage symptoms and improve heart function.
  • Patient consults with a cardiac surgeon to discuss the risks and benefits of bypass surgery and to plan the procedure.

During heart bypass surgery:

  • Patient is placed under general anesthesia.
  • Surgeon makes an incision in the chest and opens the rib cage to access the heart.
  • A heart-lung machine is used to circulate oxygenated blood to the body while the heart is stopped.
  • Surgeon harvests a healthy blood vessel from another part of the body and grafts it onto the blocked coronary artery to bypass the blockage.
  • Once the graft is in place, the heart is restarted and the chest is closed.

After heart bypass surgery:

  • Patient is transferred to the intensive care unit (ICU) for monitoring and recovery.
  • Patient may experience pain, fatigue, and difficulty breathing in the immediate postoperative period.
  • Patient undergoes cardiac rehabilitation to regain strength and improve cardiovascular health.
  • Patient is monitored for complications such as bleeding, infection, and arrhythmias.
  • Patient is discharged from the hospital and continues follow-up care with their healthcare team to monitor recovery and manage any ongoing heart conditions.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing heart bypass surgery?
  2. How will the use of hypothermic cardiopulmonary bypass during the surgery affect my recovery and outcomes?
  3. What is the difference in outcomes between mild hypothermia CPB and normothermia CPB?
  4. How will the different target temperatures during CPB affect my risk of bleeding and other complications?
  5. What factors are considered when determining the optimal target temperature for CPB in my case?
  6. How will the levels of coagulation and inflammatory factors be monitored during and after the surgery?
  7. What is the expected length of stay in the ICU and hospital following the surgery?
  8. What are the potential long-term effects or complications associated with the use of hypothermic CPB during heart bypass surgery?
  9. How will postoperative care and monitoring be different based on the temperature strategy used during CPB?
  10. Are there any alternative approaches or techniques that could be considered for my specific case?

Reference

Authors: Wang J, Wang T, Zhang H, Zhang Q, Liu G, Yan S, Wang Q, Teng Y, Wang J, Hu Q, Ji B. Journal: BMC Surg. 2024 Oct 22;24(1):323. doi: 10.1186/s12893-024-02634-6. PMID: 39438868