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For one Stanford doctor, the beat goes on during open-heart surgery

In a Stanford Hospital surgery room on a recent afternoon, heart surgeon Kai Ihnken demonstrated how he repositions the beating heart while it's still inside the chest of a 78-year-old man undergoing triple bypass surgery. The surgeon reached into the chest, lifted the beating heart out, then craned his neck to the side, just so, searching for the right spot on the back of the heart to attach the next vessel.

Ihnken, MD, clinical assistant professor of cardiothoracic surgery at the Stanford University School of Medicine, was using an innovative technique called "beating-heart" surgery for coronary bypass. It replaces the more conventional use of a heart-lung machine, which allows for stopping the heart during surgery.

"It's very, very technically demanding," said Ihnken discussing the challenge of working on a still-beating heart shortly before he stepped into surgery to do so. "Surgeons don't want to put up with the stress. But it's so beneficial for the patient."

Despite its reputation as a technically tricky procedure, beating-heart surgery has garnered renewed attention recently as the trend toward less-invasive methods of heart surgery grows stronger.

"We need to be researching this," said Robert Robbins, MD, chair of the cardiothoracic surgery department at the School of Medicine, who hired Ihnken this summer to lead investigations into the potential benefits of less-invasive surgeries such as beating-heart and robotic heart surgery. "We need to make it available to our patients."

Currently, most heart surgeons use the more conventional method of putting a patient on a heart-lung machine, aka "the pump," for bypass surgeries. The pump lets the surgeon stop the heart by keeping blood circulating throughout the body, which keeps the patient alive, while the doctor sews on new vessels. It's easier for surgeons to perform because they have a stable target. The heart is not moving.

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Source:Stanford University Medical Center


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