Seiich Noda, M.D., of the SSM Heart Institute is one of the few cardiac surgeons who perform off-pump (beating heart) bypass surgery in St. Louis.  Only about 20 percent of all heart bypass procedures in the United States are done off-pump, despite the neuro-cognitive benefits it holds over conventional heart surgery.

Taking things a step further, a new, even rarer "clampless" method of beating heart surgery is being performed by Dr. Noda, made possible by the development of a "Heartstring" device about five years ago. 

"The Heartstring device takes the most dangerous step of the off-pump bypass procedure and eliminates it," says Dr. Noda.

Conventionally, clamps are used to seal bleeding vessels at the bypass graft site. Placing and then releasing the clamps may dislodge plaque particles into the blood stream, which can embolize in the brain, leading to stroke, or damaging the kidneys or liver.

In contrast, Dr. Noda plugs the Heartstring device through the opening needed for bypass placement. Like an umbrella, the wound-up heartstring unfurls once underneath the opening to gently seal the hole.  As a further precaution, an ultrasound picture taken before the procedure helps the surgeon determine the best site (with the least plaque build-up) to perform the anastomosis.

As many as two to three percent of conventional heart surgery patients experience post-surgical strokes, primarily due to embolic issues.  Dr. Noda has performed roughly 200 clampless off-pump procedures the past year and a half without a single embolic stroke.

Clampless off-pump surgery offers other advantages:

• Cuts in half average length of heart surgery (two hours compared to four)
• Fewer patients require blood transfusions (8 percent of beating heart patients; 35 to 40 percent of conventional heart surgery patients)
• Decreased post-op ventilator usage
• Hospital discharge often within two to three days after surgery

Dr. Noda is among the area's leading off-pump practitioners and has performed nearly 1,200 beating heart surgeries.  He can be reached for inquiries or referrals through the SSM Heart Institute. Call 314/647-8269.