A Stony Brook University study carried out in tandem with Veterans Affairs (VA) medical centers recently concluded that a certain coronary bypass procedure performed without a heart-lung machine showed no benefit over conventional “on-pump” methods.
Together with colleagues from 18 VA medical centers, A. Laurie Shroyer, a preventive medicine professor at Stony Brook and the Northport VA Medical Center, said data pointed to better outcomes in coronary-artery bypass grafting (CABG) patients receiving the traditional technique than for those treated without a heart-lung machine.
A heart-lung machine, or cardiopulmonary bypass pump, has been commonly used for three decades with CABG patients. Some interest arose in performing surgeries without the device based on practitioner concerns over possible heart damage and related complications, Shroyer said.
“Earlier studies showed some advantages of CABG surgery using the off-pump procedure, including quicker recovery and less impact on cognitive function, but our large multicenter study contradicts these earlier findings,” said Shroyer. “In fact, the VA study indicates a consistent trend toward better outcomes in patients who had undergone the conventional on-pump technique, with better one-year composite outcomes and grafts remaining open at one year for on-pump patients.”
Shroyer and her team, who published their findings in a recent issue of The New England Journal of Medicine, said further research is advisable.