Memorial Hermann Foundation Windows, Page 3
Winter 2002

While leading edge technology is often the province of academic medical cent3ers, two cardiovascular surgeons at one of Memorial Hermann’s community-based hospitals are embracing new technologies that can substantially improve outcomes for patient’s who require cardiac bypass surgery. Cardiovascular surgeon Dr. Donald Gibson, chief of staff at Memorial Hermann Memorial City, and member of the board of trustees of Memorial Hermann Healthcare System, and his partner Dr. Miguel Gomez, were among the first surgeons in Houston to perform “off-pump” heart bypass surgeries. Both of these experienced surgeons are enthusiastic about the remarkably improved outcomes for their patients

Until the past few years, all heart bypass patients were put on a heart-lung machine during surgery. This device allows surgeons to stop the heart from beating while they perform the delicate surgery on the heart’s blood vessels. The heart-lung machine temporarily serves as the patient’s heart and lungs, pumping blood through the machine to oxygenate the blood and then pumping the blood back into the body to deliver oxygen to the cells. Although used effectively in heart surgery for decades, putting patients on the heart-lung machine is not without risks, such as lung problems, fluid retention, stroke, abnormal heart rhythms, bleeding and death. But progressive physicians are always looking for better solutions for their patients.

Now surgeons around the world, including Dr. Gibson and Dr. Gomez, have begun using devices that allow small sections of the heart to remain immobile, while the rest of the heart continues to beat normally and perform its important job of delivering blood to the rest of the body. Dr. Gibson explains how the device works. “The device is called an ‘Octopus,’ and it has suction cups that attach tot he heart muscle on either side of the artery on which we are working. The suction cups are attached to a flexible hose that is then connected to a stabilizing bar. While the rest of the heart beats, the one-inch square area that we work on stays perfectly still. When we are done with one area, we remove the suction cups and move them to the next area.” Says Dr. Gibson.

The benefits are enormous, according to clinical studies done around the world, and according to Dr.Gibson’s and Dr. Gomez’s own two-year retrospective study on their patients. Dr. Gomez explains, “We have shorter post-operative length of stay, lower mortality and stroke rates, shorter ventilator use times and faster recovery times. This device minimizes the interference to the normal functioning of the heart, and it also usually shortens the time the patient is in surgery. Both of these are clearly better for our patients. And, shorter lengths of stay and quicker recoveries drive down costs, which is also a strong incentive.

Dr. Gibson and Dr. Gomez began doing these ”beating heart,” or “off-pump” bypass surgeries in September of 1999 on a few selected patients. The off-pump patients had such remarkably positive outcomes that within two months, they decided to do all bypass patients off-pump. Currently, they do approximately 97 percent of their bypass surgeries off-pump. Not only is this the highest percentage of off-pump bypasses being done in the Houston area, but it can also be compared to national averages of only 10 to 15 percent of all bypass surgery being done off-pump. Occasionally, because of other medical complications, they will use the heart-lung machine on a patient, but that is the rare exception.

Dr. Gibson believes that this sort of leading edge medicine is becoming more common I the community –based hospitals around the country. “Not all of the latest and greatest technology is concentrated in the academic medical centers. Many community hospitals are just as progressive, if not more so, with these new clinical procedures. We have great support here at Memorial Hermann Memorial City, and we plan on continuing to improve patient care in whatever ways we can.”

So, what does this new procedure mean to patients who might be needing bypass-surgery? “I saw an off-pump bypass patient sitting up in bed reading the newspaper in the evening of the day he had surgery.” Says Dr. Gomez. “That may not seem like a big accomplishment, but when you consider how major this surgery is, it is really quite remarkable.