( y used in about 22 percent of U.S. bypa...)For one Stanford doctor, the beat goes on during open-heart surgery

The hesitancy of most surgeons to switch to beating-heart surgery is, in part, due to the overall success of the heart-lung machine over the past 40 years. In other words, if it ain't broke, why fix it?

But proponents of beating-heart surgery, such as Ihnken, point to the risks associated with conventional bypass surgery, including blood loss, stroke and kidney failure. Because the body doesn't have the added stress of being put on a heart-lung machine, beating-heart surgery can reduce these risks, and does so particularly well among such high-risk groups as the elderly and, surprisingly, women, Ihnken said.

"For reasons not well-understood, women don't do as well during bypass as men," Ihnken said. "Women have double the mortality rates following bypass."

Besides his own positive experiences with the technique, Ihnken points to a recent report in the new journal Innovations, which presents an analysis by an international group of doctors of more than 150 previous studies of the procedure. It found that the beating-heart technique is as safe as conventional heart surgery, with fewer complications and lower costs. The consensus report, based on randomized controlled trials and retrospective studies, concluded that when complications such as blood loss, stroke, kidney failure and irregular heart beats were considered, beating-heart surgery had a definite advantage over conventional bypass.

"Beating-heart surgery is an advance in cardiac surgery because it provides a better result for patients," said John Puskas, chief of cardiothoracic surgery at Emory Crawford Long Hospital, Atlanta, and one of the 12 authors of the paper.