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Surgeon Experience May Be Key to Best Outcome

Mike Mitka

JAMA. 2004;291:1821-1822.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Coronary artery bypass grafting (CABG), aided by a heart-lung machine to pump blood while the heart is temporarily immobilized, is one of the great medical advances of the 20th century. But some researchers are saying bypass surgery without such mechanical assistance may be even better in terms of reduced morbidity and cost.

The heart-lung machine, which provides the cardiac surgeon with a stable and bloodless environment in which to operate, is currently used for about 77% of all heart bypass cases. But there is morbidity associated with "on-pump" CABG, including heart damage, stroke, and wound infection.

As an alternative, some surgeons are performing "off-pump" CABG, in which a stabilizing device is used on the beating heart, allowing the surgeon to work without any need for the heart-lung machine. Advocates for off-pump CABG argue that it costs less than on-pump CABG and may be better tolerated by patients, as . . . [Full Text of this Article]

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Off-Pump Surgery Is Associated With Reduced Occurrence of Stroke and Other Morbidity as Compared With Traditional Coronary Artery Bypass Grafting: A Meta-Analysis of Systematically Reviewed Trials * Supplemental Appendix I
Sedrakyan et al.
Stroke 2006;37:2759-2769.
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