Women are known to have a higher risk of death and complications following bypass surgery for heart disease, but recent research suggests the operation is safer for women if it is done on a beating heart.
In coronary artery bypass grafting (CABG), surgeons create a detour around blocked blood vessels that feed the heart. In the standard procedure, patients are connected to a pump that takes over the function of the heart and lungs, and the heart is stopped temporarily. The newer “off-pump” procedure employs specially designed tools that allow the surgeon to perform CABG on a beating heart.
U.S. researchers compared off-pump and on-pump CABG and found that beating-heart surgery allowed women to have just as good an outcome as men after the procedure. “Women undergoing coronary artery bypass surgery are at increased risk of death, stroke, (heart attack) and numerous other adverse outcomes compared with men,” says Dr. John Puskas from Emory University in Atlanta. “(Off-pump CABG) benefits both men and women and reduces that gender disparity in clinical outcomes.”
Puskas and his colleagues studied more than 40,000 patients who had CABG during 2004 and 2005. The analysis showed off-pump CABG reduced the risk of death in all patients by 17 per cent compared with on-pump surgery, and reduced the risk of stroke and heart attack by 35 per cent and 33 per cent, respectively.
While men who had off-pump CABG had only a slightly lower risk of death compared with men who had on-pump surgery, women who underwent the off-pump procedure had a significant 24 per cent lower risk of death than women who had on-pump surgery.
“We should be doing more off-pump surgery, especially for women,” Puskas says.