Why is it that “Japan is the most advanced country in the world for off-pump coronary bypass operations,” as Dr. Niinami declares?

There are three main methods of treating angina (when the coronary artery narrows) and heart attack (when the coronary artery is blocked): drug therapy, coronary artery catheterization or coronary artery bypass. A coronary artery bypass is performed in cases where attacks cannot be controlled by drugs, constriction in the coronary artery is difficult to reach with catheterization, there are risks associated with catheterization, or there is narrowing in more than one location. 

Another blood vessel is used as a graft to create a detour, or bypass, to restore blood circulation to normal. It used to be standard procedure to temporarily stop the heart and use a heart-lung machine, essentially a pump, to artificially perform the functions of the heart and lungs to circulate blood throughout the body while performing the bypass. 

However, in Japan 70% of these operations are now performed using the so-called off-pump method, which is performed with the heart still beating, using an instrument called a stabilizer to inhibit vibrations in the sections being sutured. The greatest merit of this procedure is that the physical strain on the patient’s heart and body is greatly reduced, leading to a faster postoperative recovery. Although heart-lung machines are extremely safe, it cannot be denied that stopping the heart and putting a patient into a state of suspended animation for a long period inflicts damage on their body.


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