Beating Heart Bypass Surgery Boon for Elderly Patients; Experts

By 1 2 1 News Reporter

Chandigarh 15^th September:-- Unlike conventional on pump coronary artery bypass surgery where surgeries are performed on a stopped heart by medication, the beating heart bypass surgery is a safe and proven option for elderly patients. In conventional practice where a heart-lung machine takes over the function of patient's heart and lungs during the surgery, an Octopus Tissue Stabilizer (OTS), which is designed to position and to hold the heart, gives  surgeon easy access to the blocked vessel requiring the bypass graft. OTS minimizes and limits the motion of a small area of the heart while the rest of the heart continues to beat normally. This allows the surgeon to perform CABG surgery without stopping heart and without using the heart-lung machine.

Dr Virendar Sarwal, Principal Consultant & Chief of Dept. of Cardiothoracic & Vascular Surgery at Max Super Speciality Hospital, Mohali who have performed a successful beating heart bypass surgery on 84-yr old , Surat Singh recently says that elderly patients as compare to young patients carry a greater burden of risk factors and reduced functional levels. Beating heart eliminates the need for heart lung machine which results in fewer side effects. Some potential benefits of beating heart surgery are lower risk of stroke, fewer problems with memory loss and thinking skills, reduced injury to the heart, fewer heart rhythm problems and shorter hospital stay, points out Dr Sarwal.

He says further the surgery allows improvement or complete relief of the symptoms and being symptom-free for several years. The patient may recover from surgery more quickly than those who go "on pump" and they may suffer from fewer post-operative complications.Talking about the beating heart bypass surgery of Surat Singh , Dr Sarwal informs, all his three major heart arteries were more than 90 percent blocked. Along with this complication, the arteries going to his brain were also blocked on both sides by 90% and 60%. Dr Sarwal along with his team of operating surgeons took extra care to avoid brain damage during surgery especially because of acute blood pressure variations. The patients CT Scan showed dilated lateral ventricles and loss of brain cells (Cerebral Atrophy). As there was no evidence of any major stroke, the team decided to go ahead with beating heart bypass while taking special precautions in the OT. Three grafts were given to him on beating heart by using OTS Post surgery, Surat Singh was fully mobilized and discharged from the hospital within 5 days, says Dr Sarwal.

It has been observed that with elderly patients, the risk of undergoing an open heart surgery is very high as all organs of the body are aging due to wear and tear which also makes it difficult for the body to undertake the stress of surgery. But with technological advancement in the field of medicine, beating heart surgery is now an established technique in the field of cardiac surgery and is also an ideal option for elderly patients. However, at our end, we the clinicians, always weigh the surgery's risks and benefits for the patient by taking into account several health factors and not just age alone, remarks Dr Sarwal.  The challenge in beating heart CABG surgery is that it can be difficult to suture or "sew" on a beating heart. The surgeon must use a "stabilization" system to keep the heart steady. The stabilization system consists of a heart positioner and a tissue stabilizer.