Poorer Outcomes After 'Off-Pump' Bypa...(rtise and patient characteristics but t...),Health

"Some surgeons around the country do off-pump bypass and they are very accomplished at it," he said. "Most haven't done the long-term follow-up that we have done, but they have pretty good results, and I would doubt they would change their practice. But those who haven't taken it on are less likely to take it on."

Grover said he would continue to do off-pump bypass surgery for some patients -- those who are elderly, who have major disabilities or have suffered previous strokes. "I would do it for Jehovah's Witnesses, who can't take [donated] blood," he said.

Another expert agreed. Off-pump bypass surgery will continue to be done, said Dr. Eric David Peterson, a professor of medicine at Duke University, even though the newly reported study, which he noted is larger than any done before, does not show the expected benefits.

"Surgeons who use it would say the results are about the same, and in their hands it would be an attractive alternative," Peterson said. "But for the physician who has not yet mastered it, this [off-pump surgery] would not be necessary because conventional means are at least as good, if not better."

The verdict in the study for bypass surgery in general was favorable, Peterson said. "Both methods look remarkably good, with very little effect on neurocognitive function," he said.

The study does not disprove the possible benefits of off-pump surgery for older, sicker people, Peterson said. The men who had bypass operations in the study were "a bit younger than average, and their risks are a little lower than what you see in the general bypass population," he noted.

"Those populations thought to be at most risk for complications probably were not enrolled in this study," Peterson said. "Off-pump bypass may have a role there."

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