Newer Bypass Surgery Stacks Up Against Older Method
January 29, 2003 02:33:22 PM PST
A type of bypass surgery that eliminates the need to stop a patient's heart from beating is comparable to traditional surgery for those with relatively mild heart disease, researchers reported Wednesday. What's more, the technique appears to be slightly cheaper.
After one year, patients who had so-called "off-pump" bypass surgery, during which only a portion of the heart is immobilized, had virtually the same rates of survival, stroke, heart attack or additional treatments as those who had standard bypass surgery.
During conventional bypass surgery, a person's heart is stopped and a heart-lung machine is used to circulate blood during the operation.
The current findings may not apply to people with more extensive heart disease, such as blockages in three or more places in heart arteries, according to the findings published in the January 30th issue of The New England Journal of Medicine ( news - web sites). Many patients undergoing bypass surgery have blockages in three or more arteries and only 1% have a blockage in a single artery.
In the study, Dr. Hendrik M. Nathoe of University Medical Center Utrecht in The Netherlands and colleagues followed two groups of patients with blockages in one or two heart arteries. In all, 139 patients underwent traditional, or "on-pump" surgery, while 142 had off pump surgery.
A year later, about 90% of patients in both groups were alive and had not had a stroke, heart attack or further artery-clearing procedure. Overall, the researchers estimate that on-pump surgery had direct medical costs that were $1,839 more than off-pump surgery ($14,908 vs. $13,069). "The findings ... document a significant, 14% cost savings with off-pump as compared with on pump surgery, representing a potentially important societal benefit," writes Dr. Eric A. Rose of Columbia University College of Physicians and Surgeons in New York City in an accompanying editorial. Overall, the findings show "the potential clinical value of the off-pump surgical approach in low-risk patients yet fail to establish its material superiority over conventional surgery," adds Rose.
The off-pump surgery was conducted during the study using a device invented at the University Medical Center Utrecht and some of the researchers are entitled to compensation from sales of the device, http://www.100md.com
A type of bypass surgery that eliminates the need to stop a patient's heart from beating is comparable to traditional surgery for those with relatively mild heart disease, researchers reported Wednesday. What's more, the technique appears to be slightly cheaper.
After one year, patients who had so-called "off-pump" bypass surgery, during which only a portion of the heart is immobilized, had virtually the same rates of survival, stroke, heart attack or additional treatments as those who had standard bypass surgery.
During conventional bypass surgery, a person's heart is stopped and a heart-lung machine is used to circulate blood during the operation.
The current findings may not apply to people with more extensive heart disease, such as blockages in three or more places in heart arteries, according to the findings published in the January 30th issue of The New England Journal of Medicine ( news - web sites). Many patients undergoing bypass surgery have blockages in three or more arteries and only 1% have a blockage in a single artery.
In the study, Dr. Hendrik M. Nathoe of University Medical Center Utrecht in The Netherlands and colleagues followed two groups of patients with blockages in one or two heart arteries. In all, 139 patients underwent traditional, or "on-pump" surgery, while 142 had off pump surgery.
A year later, about 90% of patients in both groups were alive and had not had a stroke, heart attack or further artery-clearing procedure. Overall, the researchers estimate that on-pump surgery had direct medical costs that were $1,839 more than off-pump surgery ($14,908 vs. $13,069). "The findings ... document a significant, 14% cost savings with off-pump as compared with on pump surgery, representing a potentially important societal benefit," writes Dr. Eric A. Rose of Columbia University College of Physicians and Surgeons in New York City in an accompanying editorial. Overall, the findings show "the potential clinical value of the off-pump surgical approach in low-risk patients yet fail to establish its material superiority over conventional surgery," adds Rose.
The off-pump surgery was conducted during the study using a device invented at the University Medical Center Utrecht and some of the researchers are entitled to compensation from sales of the device, http://www.100md.com