Heart surgeon breaks through with new procedure

Dr. Husam Balkhy, a cardiothoracic surgeon and chairman of the Department of Cardiothoracic Surgery at The Wisconsin Heart Hospital in Wauwatosa, recently succeeded in performing the first total connector cardiac bypass surgery without having to stop the patient’s heart.

It was the first surgery of its kind performed in the United States.

The procedure was done using a stapling device to perform all of the connections in the bypass.

Balkhy has been performing bypass surgery with connectors on the downstream side of the graft since the U.S. Food and Drug Administration approved the first version of the Cardica C-Port distal anastomosis system in December 2005.

Recently, the FDA approved the Cardica PAS-Port proximal anastomosis system for the upstream side of the graft, which allows, in many cases, all of the connections to be made using the connectors instead of hand sewn sutures.

Hand-sewn sutures are typically a slower maneuver and can often be difficult to perform in tight spaces and on a beating heart, Balkhy said.

“There is always a risk that if you stop the heart you won’t be able to get it started again,” he said. “(This procedure) is quicker, and you have fewer complications. You just push a button and you have a connection.” 

Balkhy performed the triple bypass surgery on a 69-year-old woman. The team kept her heart beating, and it was completed in less than three hours. The patient today is doing well.

Performing surgery on a beating heart has not gained popularity among surgeons because of the extreme difficulty, Balkhy said. Only 20 to 25 percent of heart surgeons perform on a beating heart.

Using the connector on the upstream end of the bypass could also potentially decrease the risk of a stroke occurring during bypass surgery, which can be caused by over-manipulation of the aorta artery, Balkhy said.

Performing the surgery with the connectors, instead of hand-sewing the connections, can decrease the amount of time the patient is under anesthesia, which can be beneficial toward the amount of time needed for recovery.

“The time it takes to perform the surgery can be significantly decreased from around four hours to around two-and-a-half to three,” Balkhy said. “This can also then decrease the amount of time the patient is out of work. Working patients will benefit from this type of surgery significantly, by reducing the amount of money lost from missed work.”

Balkhy is hopeful about the new procedure because it has the potential to allow bypass surgery to be done without having to open up the breast bone.

“Opening up the breast bone causes a large portion of the patient’s recovery time,” he said. “Knowing that this could potentially lead to an even less invasive surgery means reduced risk and decreased time of recovery and pain associated with it.”

Balkhy was a recipient of a Small Business Times Health Care Heroes Award in 2004.

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