DALLAS -- Whether doctors perform bypass surgery on a stopped heart using a heart-lung machine or on a beating heart, the patient fares about the same, a large analysis concludes.
''The bottom line is you can get a very good operation using either technique," said lead author Dr. Frank Sellke, who serves on a surgical panel of the American Heart Association. ''The advantages and disadvantages tend to be quite small when you compare one to the other."
The review by the heart association might help resolve a long-running debate over which bypass technique is best: the standard procedure of stopping the heart and using a heart-lung machine or the newer method of operating with the heart still beating.
The ''off-pump" operation, in which the still-beating heart is held by a device while the bypass graft is sewn in place, began to gain ground about 10 years ago.
''It's been debated quite vehemently for a number of years," said Sellke, who is also chief of cardiothoracic surgery at Beth Israel Deaconess Medical Center in Boston and a professor at Harvard Medical School.
Dr. Harold Urschel of Baylor University Medical Center said: ''Initially, we would have expected a lot better results with the off-pump. People are backing off of it now because there's not an advantage of using it in the standard case and it's a little harder for the surgeon."
''The key is to try to figure out what might be the right operation for each individual patient," said Dr. Walter Merrill, chief of cardiothoracic surgery at University of Cincinnati College of Medicine.