Beating Heart Surgery, as the term suggests, is the surgery performed on a beating heart, that is, without stopping it. Surgeons use a special type of device to stabilize the part which they have to operate on and let the heart do its function of rotating blood through muscles uninterrupted. This method has tremendously curtailed the associated risks of heart surgeries that were earlier considered a threat to life, when this technique was not available, and heart had to be stopped for the operation, temporarily though.
Even today many surgeries are performed on heart because they require a motionless heart to operate on. A cold crystalloid solution is infused into the coronary circulation to stop the heart and this procedure is called Cardioplegia. After surgery, the heart is restarted and blood is reintroduced into the tissue. This process of restarting the heart is known as Reperfusion. The possible risks of the process are impairment of cardiac activities, and damage to heart tissues during the process. This damage occurs at cellular level and is known as Reperfusion injury. The damage can later result in serious heart problems like arrhythmias and even strokes. Risk level gets higher for high-risk patients such as elderly people, or those with a history of several heart surgeries, those who have serious blockages, and individuals with High Blood Pressure, other heart related problems or any complex health issues.
This is where beating heart surgery comes to the rescue of the patient. Reperfusion is not the part of beating heart surgery hence there is no risk of reperfusion injury in beating heart surgery. Some common benefits of beating heart surgeries can be outlined as:
- Better restoration of heart function
- Lower risk of injury or impairment
- Lower hospitalization period
- Faster recovery
- Less impact on other body organs like kidney, liver, etc.
- Lower risk of other complications like stroke, memory problem, neurological injury, etc.
Generally, where technology and trained surgeons are available, most coronary artery bypass surgeries are performed on a beating heart. This is what any cardiac surgeon would recommend. The expert surgeons even make it an option in many other complicated surgeries where all procedures can not be performed on a beating heart, for example, valve repairing. In a highly advanced technological environment, surgeons are capable of performing mitral valve surgery and can treat valve disease on a beatin heart.
Some of the surgical procedures that can be performed on a beating heart are:
- Coronary Artery bypass graft surgery
- Atrial Fibrillation surgery
- Some congenital heart problems
- Mitral or tricuspid valve replacement
- Ventricular restoration
It is a general concept that beating heart surgery is an ‘off-pump’ surgery which does not use heart-lung bypass machine but this is not always true. Some of the heart surgeries such as ‘coronary artery bypass’ can be performed without using heart-lung bypass machine, but in some selected procedures, it is used to pump-up the circulation. There are some beating heart surgeries which can not be performed without using a heart-lung bypass machine.