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Surgery bypasses heart-lung machine

(CNN) - Doctors called it beating heart surgery.

Just 15 percent of doctors around the world have learned how to perform heart bypass on a still-beating organ, which is immobilized in small sections by a vacuum-like device for arterial grafting and repair.

"Specifically, we hold still the coronary artery that we're sewing the graft to and then work with that artery," explained Dr. John Puskas, an assistant professor of surgery at the Emory University School of Medicine in Atlanta, Georgia. "Then (we) move to the next part of the heart that needs another graft."

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In traditional heart bypass, a patient's heart is stopped while surgeons work. Blood continues to be circulated throughout the rest of the body by a heart-lung machine. But there are risks.

"The heart-lung machine causes some inflammation that affects the brain and every organ in the body," said Puskas. "Most patients tolerate that inflammation very, very well and do fine."

But a study in this week's New England Journal of Medicine suggests that for a significant number of people, a decline in mental acuity that has long been known to be associated with heart bypass may be, in fact, permanent.

The study of 261 bypass patients found that five years after the operation, 40 percent showed a drop in mental ability similar to that normally experienced between the ages of 40 and 60.

"Neurocognitive dysfunction occurs in up to 60 to 70 percent of all patients undergoing coronary bypass," said neurologist Denise Barbut, former director of stroke research at the Weill Medical College of Cornell University in Ithaca, New York.

CNN Medical Correspondent Rhonda Rowland reports.



RELATED STORY:
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RELATED SITES:
Emory University
Cornell University
New England Journal of Medicine
American Heart Association

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