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Bypass Patients Fare Equally Well With or Without Heart-Lung Machine
Date:3/12/2013

By E.J. Mundell
HealthDay Reporter

MONDAY, March 11 (HealthDay News) -- Coronary artery bypass surgeries are one of the most common heart operations, and three new studies find it makes little difference whether they are done with or without the aid of a heart-lung machine.

Patients having so-called "off-pump" (no heart-lung machine) bypass procedures fared equally well as those who got the "on-pump" version, even if they were very sick or elderly, the trio of studies found. On the other hand, patients who had bypass with the aid of a heart-lung machine also had no evidence of a higher risk of lowered mental function afterwards, something that prior studies had suggested might be a concern.

The studies were presented Monday in San Francisco at the annual meeting of the American College of Cardiology (ACC).

Bypass surgery involves the transplant of a vessel sourced from elsewhere in the patient's body to "bypass" a clogged artery servicing the heart. The procedure can be done while the heart is temporarily stopped and the patient is placed on a heart-lung machine, or it can be done in an "off-pump" mode, in which the surgeon lifts the still-beating heart out of the chest cavity to perform the necessary grafts.

Initially, experts worried that off-pump bypass might be too risky, especially for more frail patients. But the three new studies suggest otherwise.

One comparison study, the largest yet performed, was led by Dr. Andre Lamy of the division of cardiac surgery at McMaster University in Hamilton, Ontario. The trial involved more than 4,750 patients from 79 centers across 19 countries, who were scheduled to undergo bypass.

After one year of follow-up, the team found no significant difference in rates of death, stroke, heart attack or new kidney failure for people who got the off-pump procedure (12.2 percent) and those who got the on-pump version (13.3 percent).

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