The beat goes on
A new form of bypass surgery means faster, easier recoveries

An exciting new way of performing bypass surgery is fast becoming the norm at Advocate Lutheran General Hospital. Instead of stopping the heart completely with the use of a heart-lung machine, Lutheran General Hospital doctors use drugs and special stabilizers to hold sections of the heart still during surgery. Recoveries are faster and smoother with the new technique, says Lutheran General Hospital cardiac surgeon Axel Joob, M.D.

“Almost 97 percent of our patients who require surgery for blocked arteries undergo the new procedure,” Dr. Joob says. “We are so pleased with the recoveries that we use the off-pump coronary artery bypass (OPCAB) whenever possible.”

Keeping hearts in motion
In traditional bypass surgery, the heart is completely stopped to provide the surgeon with a motionless surface on which to operate. Because it is stopped, the heart can’t perform its function of circulating blood around the body, and a heart-lung machine must take over this crucial job.

New equipment and techniques, however, make it possible to hold a small portion of the heart still. During OPCAB, physicians use drugs and stabilizers to hold the blocked areas motionless while the surgeon performs the bypass.

Reducing complications
Although the heart-lung machine used in traditional bypass surgeries revolutionized surgery, it also may be behind some surgery-related complications, including stroke and kidney failure. When a patient is on a heart-lung machine, tubes carry blood from the body to the machine and back again. Tiny particles or clots can get caught in the bloodstream inside these tubes. Some doctors believe that the particles interfere with blood flow to the brain and cause mental difficulties, such as memory loss, which some people experience following bypass.

“In our experience, patients who had off-pump surgery did significantly better than those on the pump,” notes Lutheran General Hospital cardiac surgeon Janice Klich, M.D. “They were more alert during the early recovery period and had less of the mental fogginess we sometimes see in patients who used the heart-lung machine.”

OPCAB also reduces the usual hospital stay at Lutheran General Hospital. “Because they haven’t had their blood flow mechanically controlled, OPCAB patients undergo fewer overall physiological changes,” Dr. Klich says. “We believe this accounts for the shorter hospitalization.”

Nearly everyone requiring bypass surgery is a candidate for OPCAB, according to Dr. Joob. “In the past, OPCAB could only be used for patients with one or two blocked arteries, but now the technique is so sophisticated it can be used for patients who need quadruple or even quintuple bypass surgery,” he says. “We want as many of our patients as possible to have access to this exciting new technology.”