Surgery On A Beating Heart

More than a half a million people need heart bypass surgery every year, and doctors are now able to reduce some of the risks by performing the operation directly on a beating heart.

The Early Show medical correspondent Dr. Emily Senay explains that bypass surgery is one of the most effective way of fixing a heart that is no longer getting enough oxygen from clogged blood vessels that feed it.

Normally, doctors stop the heart during surgery to hold it still during the delicate procedure — using a heart-lung machine to circulate blood through the body. But in some cases, doctors are now using a procedure called beating heart surgery. The latest technology lets the surgeon perform the operation as the heart continues to beat, using a device to stabilize the area of the heart that requires surgery.

It's a technique that's safe and effective, says Senay. And, it is gaining more acceptance in the medical community. She says the procedure may be an option for certain patients who may not be suited for the heart-lung machine. It also reduces the risk of complications associated with the use of the heart-lung machine, including mental confusion, memory loss and stroke.

It is not fully understood what causes neurological complication in bypass patients, but a new study from the University of Hawaii shows for the first time that tiny microscopic blood clots released into the bloodstream during bypass surgery are 30 times more abundant in patients who went on the heart-lung machine than those who had beating heart surgery.

The researcher also found that patients on the heart-lung machine had reduced blood flow to certain areas of the brain.

Senay says a candidate for the beating heart surgery would be someone who might be at a greater risk from being put on the heart-lung machine, such as an elderly patient or someone with other medical problems.

Some doctors prefer to operate on elderly people without the heart-lung machine, because studies suggest the elderly tend to have neurological complications more often and are at higher risk of a stroke afterward.

Senay says the new heart procedure does not make the heart-lung machine obsolete. In fact, for some patients, the beating heart surgery is not an option. Many doctors want to be sure that beating heart surgery has the same good, long-lasting results that traditional surgery has shown in the long term.

Senay says the technology is still evolving. But if the long-term results are good, then its use is likely to increase in the future.