To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Minimally Invasive Heart Bypass Procedure Found Effective URL: http://www.pslgroup.com/dg/DACE.htm Doctor's Guide November 11, 1996
NEW ORLEANS, Nov. 11, 1996 -- A minimally invasive surgical technique that allows cardiothoracic surgeons to operate on a beating heart via a small incision offers advantages over conventional coronary artery bypass surgery, according to a study being presented today at the American Heart Association's 69th Scientific Sessions by James Magovern, M.D., chief of cardiothoracic research at Allegheny General Hospital (AGH) in Pittsburgh. Often referred to as "keyhole" heart bypass surgery, the relatively new procedure holds the promise of lower hospital costs, less pain and a faster recovery, said Magovern who is also an associate professor of surgery at Allegheny University of the Health Sciences. A research team lead by Magovern compared results of 48 patients operated on with the "keyhole" approach to those of 55 patients who underwent conventional bypass surgery between January 1995 and April 1996. They found no deaths in either group, but patients undergoing the traditional surgery experienced more complications. Looking at early follow-up results, Magovern and his colleagues note that "keyhole" patients had less blood loss than conventional bypass patients -- average: 178 milliliters vs. 386 milliliters, although blood loss varied widely in both groups. Only eight of the 48 "keyhole" patients required blood transfusions, compared with 22 of the 55 patients having conventional surgery. Keyhole patients also spent less time on breathing tubes -- average: 2.7 hours vs. 15 hours, had shorter hospital stays -- average: 3.3 days vs. 7.8 days, and approximately 40 percent lower in-hospital costs. Both the "keyhole" and conventional heart bypass techniques treat coronary artery disease by shunting blood around severely narrowed or blocked sections of one or more arteries. The shunts are blood vessels grafted onto the arteries from other parts of the body -- usually the leg. Conventional coronary artery bypass surgery requires that the sternum -- or breastbone -- be cracked and separated, the heart stopped and blood circulated through the body by a heart lung machine. Although heart lung machines play a vital role, they also cause "blood activation" which may lead to abnormal bleeding, inflammation and lung dysfunction, Magovern said. While surgeons first began operating on beating hearts in the late 1980s to eliminate the need for and risks associated with heart lung machines, separation of the breastbone was still necessary. With the "keyhole" procedure, surgeons make a small incision about 3 inches in length underneath the left breast to create a "window" through the ribcage. As with traditional surgery, the left internal mammary artery was used to bypass a blockage in the left anterior descending coronary artery. "Overall the minimally invasive approach was easier on the patient, caused fewer complications and was less costly," Magovern said. "We've been keeping track, and we don't have anything that would change our initial findings. It's continuing to look good." At the moment, minimally invasive heart bypass has proven effective for patients needing only one bypass, Magovern explained, estimating that 10% of heart disease patients benefit from the procedure. Surgeons are optimistic, however, that the evolution of "keyhole" surgery will soon apply it to more complicated heart disease cases, requiring multiple coronary artery bypasses. Co-authors in Dr. Magovern's study included Michael J. Mack, M.D., of Columbia Hospital in Dallas, Tea Acuff, M.D., of HCA Medical Center in Plano, Texas and Daniel Benckart, M.D., Timothy Hunter, M.D. and George Magovern Jr., M.D. of Allegheny General. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.