Operating On A Beating Heart

Aug. 14 -- Heart bypass operations have become routine solutions for blocked arteries. During the operation the heart is stopped and machines keep the blood and oxygen pumping. Now a Stanford doctor chooses a challenging alternative and his approach is much better for patients.

Thomas is a very lucky man.

Thomas Broughton, heart patient: "I had one artery 100-percent blocked and three 70 to 90-percent blocked."

Surprisingly, he'd had no chest pain. In fact, the blockages were detected by chance with a routine screening test.

Thomas Broughton: "I don't have symptoms."

But four blocked arteries means he's headed for big time bypass. And again he says, he's lucky.

During typical bypass surgery, the heart is stopped so surgeons can graft new veins so to bypass the heart damage. But in this case, Stanford cardiothoracic surgeon Kai Ihnken attaches bypass grafts while his heart is still beating -- kind of like changing a tire on your car while it's moving down the freeway. Pretty tricky stuff.

Kai Ihnken, M.D., Stanford Cardio-Thoracic Surgeon: "You have to bypass one to two mm coronary artery on the heart which is beating away 60 to 80 times a minute. It is definitely technically challenging."

During the operation one team of surgeons carefully harvest bypass arteries from Thomas' leg, while Dr. Ihnken's team prepares the heart for the new grafts.

Dr. Kai Ihnken: "The whole team is committed to off-pump surgery, that is very important team approach and communication."

Off-pump surgery is just that -- since the heart keeps beating, no artificial pump circulates the blood. Studies show patients seem to do better with far fewer mental and physical side-effects if the heart is not stopped and no pump is used.

Dr. Kai Ihnken: "Patients recover faster, they need less blood transfusions, they bleed less, and the higher the risk, the better the outcome for off-pump."

Guillermo's a prime example of an off-pump success story.

Guillermo Regales, off-pump surgery patient: "My first symptom was actually a burning in the chest when I was biking in the mountains."

The diagnosis  95-percent blockage of his interior descending artery. Pretty serious stuff.

Today he's back for a check-up a few weeks after his beating heart surgery and even Dr. Ihnken is impressed with his recovery.

Guillermo Regales: "I left the hospital on Wednesday and I went back to work on Monday."

Not every patient recovers that quickly. But Dr. Ihnken says off-pump surgery is so much better for patients.

Dr. Kai Ihnken: "I've completely abandoned the heart lung machine for bypass surgery."

But he warns, there is a major learning curve when operating on a beating heart.

Dr. Kai Ihnken: "It has to do with eye-hand coordination. You just adjust for the movement of the heart."

The results seem to speak for themselves.

Guillermo Regales: "I would recommend it 100-percent."

So if you're headed for bypass surgery, this may be worth considering.

Off-pump surgery is not new, but because it is difficult to learn, few doctors master it. Yet more and more studies point to fewer side-effects for patients.

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