International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) Publishes Consensus Statement On Beating Heart Bypass Surgery In INNOVATIONS
Published: Dec 01, 2005
BEVERLY, Mass., Dec. 1 /PRNewswire/ -- The International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) announced today the results of a meta-analysis and Consensus Statement of off-pump coronary artery bypass surgery (OPCAB). The Consensus Statement concluded that OPCAB, or beating heart bypass surgery, is safe and reduces many of the complications and costs of conventional coronary artery bypass surgery (CCAB).
In May 2004 ISMICS, an international organization of cardiothoracic surgeons with special interest in minimally invasive surgery, held a Consensus Conference to review data from multiple studies and to compare clinical outcomes after OPCAB with conventional bypass surgery during which the heart is stopped and the patient's blood redirected to a heart-lung machine. The conclusions of the discussion and testimony presented by the Consensus Panel at the Conference have been chronicled in an evidence-based Consensus Statement and published in the peer-reviewed journal, INNOVATIONS.
After review, the Consensus Panel concluded that with appropriate use of modern stabilizers, heart positioning devices and adequate surgeon experience, OPCAB is not only as safe as CCAB, but also reduces complications and uses fewer hospital resources. Beating heart surgery is associated with reductions in atrial fibrillation, red blood cell transfusion, low cardiac output and respiratory infections. This benefit is even more striking for certain "high-risk" patients -- women, the elderly, diabetic, dialysis patients and patients with aortic disease or poor left ventricular function -- who typically have poorer outcomes following bypass surgery.
"Beating heart surgery is an advance in cardiac surgery because it provides a better result for patients," said John Puskas, MD, co-author of the Consensus Statement, Associate Professor of Surgery at Emory University and Chief of Cardiothoracic Surgery and Director of the Clinic Research Unit Division of Cardiothoracic Surgery at Emory Crawford Long Hospital, Atlanta. "We carefully looked at all the literature and came to the conclusion that on several important points, beating heart patients came out ahead, especially if they were high-risk patients. Interestingly, women qualify as a high-risk group all by themselves. For reasons that we do not understand very well, women do not do as well during coronary bypass surgery as men. We believe that they will do better with beating heart surgery than with the conventional operation and the use of a heart-lung machine, all other things being equal."
Coronary artery bypass graft (CABG) is one of the most frequently performed operations, with approximately 30 percent of these procedures undertaken "off pump" or with the heart continuing to beat. There has been increasing interest in techniques that avoid the risks associated with the conventional operation and the use of a heart-lung machine. New techniques, such as beating heart procedures, together with new stabilization devices, attempt to improve upon an operation which has been refined over 40 years and which yields excellent clinical outcomes.
The International Society for Minimally Invasive Cardiac Surgery (ISMICS) was formed to organize and centralize the various surgical centers concerned with patient outcomes, techniques and progressive development of less invasive forms of heart surgery. Formed in 1997 by the participants of the World Congress of Minimally Invasive Cardiac Surgery at the Palais Des Congres, Paris, France, the new ISMICS is taking the leadership role in shaping the direction of less invasive cardiac surgery on a global basis. The founding membership includes representatives from all continents. INNOVATIONS is the official journal of ISMICS. It will publish papers about developments that offer to make the treatment of cardiothoracic and vascular disease less invasive than it has been.ISMICS
CONTACT: Aurelie Alger, J.D. of ISMICS, +1-978-299-4524, orAAlger@prri.com; or Bronwyn Boyd-Sanders of Dorland Global PublicRelations, +1-415-262-5224, or mobile, +1-415-517-2226, firstname.lastname@example.org, for ISMICS