Healing your heart with Off-pump bypass surgery – All you need to know about CABG

It is a known fact that the heart bypass surgery has saved thousands of lives. Let’s take a quick look at the two kinds of surgeries performed under the heart bypass category, namely

• On pump – Uses a heart-lung machine that supplies blood flow and oxygen in the blood vessels of the heart without the heart beating. 
• Off pump – The procedure is carried out while the heart is still beating without any need for a heart lung machine.

People face the coronary artery bypass when they suffer from severe heart problems. Traditionally, on-pump procedure was carried out with the help of a machine that replaces and functions like the human heart during the surgery. In lieu thereof, to overcome its disadvantages, off-pump procedure is now being used with technological advancements that stabilize the heart during the surgery. It allows the surgeon to perform the operation and bypass the blockages of arteries while the heart is still beating in a highly controlled operative environment. The heart still beats and keeps the supply of blood to the rest of the body intact. 

After a close evaluation of a patient’s cardiac activity and arteries, the decision of performing an off-pump bypass surgery is taken. Thanks to medical innovations today, all the arteries of a person can be bypassed off-pump. 

Why off-pump CABD graft?

In the traditional heart bypass procedure, there was increased morbidity such as stroke, renal failure and need for blood transfusion. There was also an increased risk of cognitive abilities seen in persons undergoing CABG with cardiopulmonary bypass. However, the revascularization was sometimes incomplete in patients undergoing the off-pump bypass surgery. The risk of death stroke, and myocardial infarction (heart attack). was eventually lowered with off-pump heart bypass procedure. 

What happens during the off-pump bypass surgery?

A section of a healthy vein is removed from an area of other body, called graft. Now, one end of the graft is sewed above the blocked artery and the other end is attacked below the blockage in the artery. After successful attachment, blood flows freely into and out of the heart. 

The major challenge with beating heart surgery is to maintain the stability of heart. The heart is already beating and to sew upon a beating heart is the test. Its literally like a dare, where the doctor first needs a stabilization system to successfully perform the operation. 

Yes, science has gifted us with a stabilization system as well. It consists of a heart positioner and a tissue stabilizer. The heart positioner guides and holds the heart in a position that provides the best access to the blocked arteries. The tissue stabilizer holds a small area of the heart still while a surgeon works on it. With all this said, the biggest benefit of an off-pump surgery is that the risk of death is reduced by 1-2%. You get your life back as gift post operation is this benefit is above all.

Let’s take a sneak peak at the risks or complications involved with the beating heart surgery. 

• Bleeding on the site of graft attachment : Sometimes, there might be an additional surgery requirement to restrict the bleeding on the grafting. 
• Heart rhythm problems : There may be irregularities in heart beat after the off-pump operation leading to clots in the heart and other parts of body. 
• Blood Clots: Blood clots may lead to cardiac arrest. 
• Memory loss : Some patients may face problems related to thinking and memory related issues. 
• Reactions to anaesthesia: Sometimes patients feel difficulty in breathing after falling asleep due to given anaesthesia. 

If you are planning for a coronary bypass surgery on an elective basis, discuss with your cardiologists to measure the pros and cons of the surgery. Your cardiac surgeon will give you the best option based on your health and cardiac condition.