Beating Heart Surgery- Off Pump Coronary Artery Surgery

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Beating Heart Surgery

Beating heart surgery, also known as off-pump coronary artery bypass, is a type of heart surgery performed while the heart is still beating. 

The beating heart surgery is different from the traditional coronary artery bypass grafting (CABG) or heart bypass surgery in which the heart is stopped, and a heart-lung machine takes over the heart’s pumping function. 

This type of heart surgery aims to reduce complications associated with the use of the heart-lung machine, such as inflammation, bleeding, and neurocognitive problems. 

How is this heart surgery different from traditional heart bypass surgery?

Beating heart surgery has the following key differences from a traditional on-pump heart bypass surgery:

• No heart-lung machine: The heart continues to beat throughout the beating heart surgery unlike an on-pump heart bypass surgery, where the heart is stopped and the heart-lung bypass machine takes over the function of the heart and the lungs.
• Stabilization devices used: In a beating heart surgery, specialized devices are used to stabilize the portion of the heart being operated on.
• Minimally-invasive surgery: A beating heart surgery usually involves smaller incisions and a minimally-invasive approach, although it may also be performed as an open-heart surgery. ( Know more about- Cost of Heart Bypass Surgery in Bangalore )

What are the different types of this type of heart surgery?

The different types of beating heart surgeries are:

• Traditional off-pump coronary artery bypass surgery: This is the most common beating heart surgery that is used primarily to bypass blocked coronary arteries. The surgeon will attach a blood vessel from another part of the body to the blocked artery, creating a new route for blood flow.
• Minimally-invasive direct coronary artery bypass surgery: This is a less invasive version of off-pump coronary bypass surgery, performed through small incisions between the ribs rather than opening the chest. This technique is suitable for certain patients with specific types of artery blockages.
• Hybrid coronary revascularization: This approach combines off-pump coronary artery bypass surgery with percutaneous coronary intervention (PCI). It is used when different blockages are best treated by different types of techniques.

What is the purpose of this type of heart surgery?

Beating heart surgery is primarily used to treat coronary artery disease (CAD), which occurs when the arteries that supply blood to the heart muscle, known as the coronary arteries, become narrowed or blocked due to plaque buildup. Beating heart surgery can help in the following ways:

• Restores blood flow to the heart muscle
• Reduces symptoms associated with heart problems like chest pain (angina) and shortness of breath
• Reduces the risk of heart attack
• Improves quality of life

What is the diagnostic procedure ?

The following diagnostic tests are recommended before undergoing a beating heart surgery:

• Physical Examination: The doctor will evaluate the patient’s medical history, including symptoms, lifestyle, and family history of heart disease. A physical examination will be done to check the overall health of the patient and if there are risk factors for heart diseases.
• Blood tests: The test helps in determining the general health of the patient and if the patient is fit to undergo surgery.
• Chest X-rays: It helps the doctor view the condition of the heart and the lungs.
• Electrocardiogram (ECG): This test helps measure the heart’s electrical activity.
• Echocardiogram: This test involves the use of ultrasound to create clear images of the heart.
• Stress test: This test helps the doctor assess how the patient’s heart performs under physical stress.
• Coronary angiography: A contrast dye is injected into the coronary arteries to visualize blockages using X-ray imaging in this test. ( Know more about- What is Heart Attack ? )

How to prepare ?

The following preparation is needed before a beating heart surgery:

• The patient needs to inform the doctor about any medicines help or she may be currently taking and any medical conditions that he or she may be having.
• The doctor may recommend stopping certain medications like blood-thinning medicines a few days before the surgery.
• The patient is asked to stop smoking at least a few days before the surgery.
• The patient needs to eat a healthy diet and exercise regularly to maintain a healthy weight before the surgery.
• The patient needs to avoid eating or drinking anything at least eight hours before the surgery.

What is the procedure?

A beating heart surgery is performed in the following way:

• The patient is made unconscious using general anesthesia before the procedure.
• The surgeon makes a large midline incision along the sternum (breastbone) for traditional open surgery. For a minimally invasive type of surgery, small incisions are made between the ribs.
• Specialized devices are then used to stabilize the section of the heart being operated on while it continues to beat.
• A blood vessel, which is usually the saphenous vein from the leg or the internal mammary artery from the chest, is harvested and grafted onto the blocked coronary artery.
• The graft is then checked for proper blood flow
• The incisions are then closed using sutures.

The surgery usually takes 3 to 6 hours to complete, depending on the number of grafts needed and the patient’s overall health.

How to care after surgery?

The following are the aftercare steps following a beating heart surgery:

• The patient will be taken to the ICU after the surgery and the vital signs will be monitored for one to two days after surgery.
• The patient will stay in the hospital for five to seven days after the surgery. The patient will start walking and doing light activities under supervision during this time.
• Some medicines will be prescribed to relieve pain, prevent the formation of blood clots, decrease cholesterol levels, and control the blood pressure levels of the patient after surgery.
• Regular follow-up appointments with the surgeon are recommended to check recovery after surgery and adjust the medications if needed.
• Cardiac rehabilitation programs are recommended after the surgery to help the patient regain strength and improve heart health through exercise, education, and counseling.

What are the risks ?

The risks associated with beating heart surgery are:

• Infection 
• Bleeding 
• Arrhythmias 
• Stroke
• Blockage of the grafted vessels
• Kidney failure
• Heart attack
• Loss of memory or cognitive abilities 

What is the cost of this surgery in India?

The total cost of beating heart surgery in India can range from around INR 3,25,000 to INR 5,25,000. The cost will be more in the case of a minimally-invasive technique compared to an open surgery.

We hope that we could answer all your questions regarding beating heart surgery through this article.

If you need more information about knee replacement surgery, you can contact a good Cardiac Surgeon at the best hospitals like Manipal Hospital Whitefield. 

We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you good advice and the correct treatment plan.