Fargo, N.D. - MeritCare heart surgeons Roxanne Newman, M.D., Ajit Damle, M.D., and Jim Burdine, M.D., are pushing the envelope to improve patient care in a field that's slow to change. The surgeons are leaders in the area of off-pump, or beating heart bypass surgery. In 2003, they performed 83 percent (402) of their bypass procedures off-pump, while nationally, it's estimated that only 25 percent of the 400,000 bypass procedures were performed off-pump.

	Dr. Newman performs off-pump bypass surgery.

MeritCare broadcasted its fourth live, surgical webcast on February 2, 2004. The organization is hoping to bring the reasons behind the differences in the MeritCare and national statistics to light, build awareness of off-pump procedures, and advocate for changes in the CV industry.

The standard for the past 25 years has been to perform heart bypass surgery on-pump, meaning that the heart is stopped from beating and patients are kept alive via a heart-lung machine. During the newer off-pump procedure, the patient's heart continues to beat.

At MeritCare, the majority of cases are performed off-pump because overall, physicians believe it may result in improved outcomes for patients, including:

• Reduced need for blood transfusions
• Faster recovery from surgery and a shorter length of stay
• Reduced risk of bleeding, stroke and kidney failure
• Reduced cognitive problems including memory loss and difficulty thinking.

Why the difference between the number of off-pump cases at MeritCare and what's occurring nationally? MeritCare's Heart Center team believes there are a variety of reasons why they're unique:

• Off-pump surgery is technically difficult and takes a great deal of expertise. Experience is also very important. Studies clearly indicate the more technical the operation, the more the surgeon's experience matters.
• When new treatment and surgical options become available, the MeritCare Heart Center team (heart surgeons, cardiologists and many other professionals) is known as an early adopter. Because of the environment of trust and respect, and the fact that the team is part of an integrated system of patient care and supporting services, they can quickly examine, debate and challenge new options and either adopt or discard them.

* Includes coronary artery bypass grafts (CABG) only for Drs. Newman, Damle and Burdine. Does not include heart valve procedures. * 2000 stats also include procedures by Drs. Molly McAfee and Robert Hieb.

Facts:

• Bypass surgery, or coronary artery bypass graft (CABG) surgery enables a blocked area of the coronary artery to be bypassed so that blood flow is not hindered. In essence, CABG surgery restores blood flow to heart tissue that has been deprived of blood because of coronary artery disease.
• Off-pump bypass surgeries first began being performed nationally in 1996.
• Nationwide, 20 percent of the heart surgeons are doing 80 percent of the beating heart procedures.
• The device used to hold the tissue of the heart in place during surgery is called the octopus.
• Because performing bypass surgery off-pump is relatively new, long-term studies on patient outcomes are not yet available.
• During the webcast, Dr. Newman will perform bypass surgery on a beating heart; Dr. Burdine, will serve as the question expert, fielding questions from viewers who log on to webcast.meritcare.com view the surgery.
• MeritCare was named a "Top 100 Cardiovascular Hospital" by Solucient in 1999, 2000, 2002 and 2003, and was named one of "America's Top Hospitals for coronary bypass surgery and heart attack" by Money Magazine in 2003.