Bypass Surgery

A new way to do bypass surgery

and the beat goes on
Despite its advantages, bypass surgery has a few drawbacks. Like the need to saw open the breastbone, stop the heart and hook up a heart-lung machine. All of that can add up to expense, hazard and time.

Surgeons have long sought to minimize these factors. In November, a Pittsburgh surgeon, James Magovern of Allegheny University, reported results for a recent series of tests on a surgery that's performed through a 3-inch slit between two ribs on the left side.

Magovern compared the post-operative results of 48 patients with keyhole surgery to 55 who had conventional bypass surgery. Both groups of patients had blockage of coronary arteries, and all patients survived the surgeries, which were performed during 1995 and 1996.

But keyhole patients spent much less time in the hospital -- an average of 3.3 days versus 7.8 for conventional patients. They lost less blood, required fewer transfusions and spent much less time with breathing tubes in their throats.

"The keyhole procedure was easier on the patients, caused fewer complications, and was less costly," says Magovern. "We've been keeping track, and we don't have anything that would change our initial findings. It's continuing to look good."

Not for everybody
Keyhole surgery may sound great, but it has some limitations, says Rodman Starke, the senior vice-president for science and medicine at the American Heart Association. Granted, nobody wants to have their breastbone split, or to have their heart stopped. But it's much easier to stitch on a still -- not beating -- heart than a beating one, and preliminary data indicate that grafts to still hearts last longer.

"The patient's doctor will have to say when it's a good idea, and when it isn't," Starke says. "It's a little premature for anybody to pound on the table and say they want this surgery. It's still in the developmental stage, and it will never be applicable for everybody."

Here's something for everybody: the home heart transplant kit.

(http://whyfiles.org/028heart/key_hole.html)



		*A new way to do bypass surgery* Despite its advantages, bypass surgery has a few drawbacks. Like the need to saw open the breastbone, stop the heart and hook up a heart-lung machine. All of that can add up to expense, hazard and time. Surgeons have long sought to minimize these factors. In November, a Pittsburgh surgeon, James Magovern of Allegheny University, reported results for a recent series of tests on a surgery that's performed through a 3-inch slit between two ribs on the left side. Magovern compared the post-operative results of 48 patients with keyhole surgery to 55 who had conventional bypass surgery. Both groups of patients had blockage of coronary arteries, and all patients survived the surgeries, which were performed during 1995 and 1996. But keyhole patients spent much less time in the hospital -- an average of 3.3 days versus 7.8 for conventional patients. They lost less blood, required fewer transfusions and spent much less time with breathing tubes in their throats. "The keyhole procedure was easier on the patients, caused fewer complications, and was less costly," says Magovern. "We've been keeping track, and we don't have anything that would change our initial findings. It's continuing to look good." Not for everybody Keyhole surgery may sound great, but it has some limitations, says Rodman Starke, the senior vice-president for science and medicine at the American Heart Association. Granted, nobody wants to have their breastbone split, or to have their heart stopped. But it's much easier to stitch on a still -- not beating -- heart than a beating one, and preliminary data indicate that grafts to still hearts last longer. "The patient's doctor will have to say when it's a good idea, and when it isn't," Starke says. "It's a little premature for anybody to pound on the table and say they want this surgery. It's still in the developmental stage, and it will never be applicable for everybody." Here's something for everybody: the home heart transplant kit. (http://whyfiles.org/028heart/key_hole.html)

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