Bypass operation on (then) Prime Minister Dr. Manmohan Singh occupied the headlines for some time. Dr. Singh made a rapid recovery and is back on the main stage. The event has brought the focus on one of the most successful and rapidly evolving surgical procedures of Modern medicine. It has also raised the question about the safety and benefits of Beating Heart bypass operation as compared to the conventional one.
What is Beating Heart (or Off-pump) Bypass Operation?
Traditionally bypass operation or CABG (Coronary Artery Bypass Grafting) is done using the help of Heart Lung Bypass (CPB or Cardio-pulmonary Bypass) machine. This machine does what heart and lungs do normally in the body. It gives Oxygen to the blood, takes away Carbon-dioxide from it and pumps the blood to all parts of the body. This enables surgeon to stop the heart and make it bloodless. Complicated surgical procedures can thus be performed safely and with greater precision. However the CPB machine is not without its share of dangers. As the blood comes in contact with the tubes and the pumps of the machine, the body systems recognize it as a ‘foreign atmosphere’ and reacts to it. This reaction can create a variety of harmful effects on different organs and some of them can even be fatal.
The idea to avoid CPB machine and its ill effects during CABG led to the concept of performing the operation on beating heart. Here the operation is done while the heart is still pumping and the lungs are working. So the support of CPB machine or ‘the pump’ is not required. Hence the name ‘Off-Pump Coronary Artery Bypass or OPCAB’. It needs no great reasoning to understand that doing the same procedure when the target is in motion demands greater care, precision and skills.