McMaster University

McMaster University

Faculty of
Health Sciences

Largest international cardiac surgery study will compare open-heart surgery with or without heart-lung machine

Published: July 11, 2008
Andre Lamy and Salim Yusuf
Dr. Andre Lamy (left) and Dr. Salim Yusuf

The world's largest cardiac surgery clinical trial, expected to involve 4,700 patients, will be undertaken by researchers at the Population Health Research Institute of McMaster University and Hamilton Health Sciences.

The trial will investigate the differences in outcomes of using on-pump versus off-pump techniques during coronary artery bypass surgery, to document and compare short- and long-tem benefits of both.

The CORONARY trial, lead by Drs. Andre Lamy and Salim Yusuf and their team of researchers, will span 7.5 years and include 4,700 participants in 100 cardiac surgical centres across 16 countries. A grant of $6.5 million has been received from the Canadian Institutes of Health Research to fund the trial.

Heart disease continues to be a major cause of death in Canada and heart bypass surgery is a common treatment. Currently, there are two different techniques used to perform heart bypass surgery: off-pump (operating on a beating heart) and on-pump (a heart lung machine is used to maintain blood circulation during surgery). Off-pump was developed in the last 10 to 15 years in an effort to decrease surgical complications typically related to on-pump surgery and associated with the heart-lung machine, which has been used since the 1960’s.

The patient recovery benefits of the off-pump technique compared with the on-pump approach are unclear. While it is believed the off-pump technique is a superior method, there is currently not enough evidence to support this theory. This study will reliably evaluate the short and long-term safety and efficacy of both techniques. Specific outcomes of interest are neurocognitive dysfunction, stroke, cardiovascular mortality, blood transfusions and quality of life.

Results from the study will determine which technique is best suited to individual patients and help develop best practices in patient care.

"Our goal is always to take cardiac care to the next level through our research," said Dr. Andre Lamy. "This trial will change practice around the world and play a key role in reducing complications for patients who undergo cardiac surgery."

Study results are expected to be available in 2011.

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