There are two ways to perform heart bypass surgery, one stops the heart while the repairs are made and the other is performed on a beating heart. But which is better?

One study said there is no difference but Channel 4 Action News medical editor Marilyn Brooks has found that this is not necessarily true.

This report originally aired on Wednesday, August 11, 2004 on Channel 4 Action News.

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It's all about selection. Both procedures are good but a lot of centers are doing this new beating heart procedure for the majority of their patients. Experts tell Marilyn Brooks that this is not a good idea.

During conventional bypass surgery the patient's heart is stopped, a heart-lung machine circulates blood through the body while surgeons attach new blood vessels to bypass clogged ones. Its 50-year history is now being challenged by a new technique.

Richard Pascarella had it done. Back in March he weighed 190 pounds, which caused type-two diabetes. Chest pains sent him straight to his doctor for tests. What did they find?

Richard Pascarella, Heart bypass patient: ”Ninety percent clogged… He was going to put stents in but he said it was useless so I had it done.

Pascarella had by-pass surgery but luckily doctors didn't stop his heart to do it. Besides three clogged arteries he had plaque in his aorta. The heart-lung machine could have been bad.

Dr. George Magovern Jr.: ”It was likely that he would break off a piece of that cholesterol, calcium whatever which could then go to the head and cause a stroke.”

Roughly one-fifth of all by-pass operations are now performed off pump but how does it stack up to the conventional operation? A recently published study said the two are equal. Experts here agree, to a point. What's easier for the patient is challenging for the surgeon

Most surgeons say if I can't do it as well as I can with the heart stopped then I'm not going to do it.

Marilyn Brooks: ”You have to understand the magic here is not in the procedure itself, it’s actually in the patient. In other words, take the beating heart procedure; it’s not for everyone. But it’s perfect for a certain subset of patients and when those patients are carefully chosen they are the ones with the greatest benefit.”

Those patients either have:

Aortic plaque

Elderly

Have several medical problems

Young and need a single bypass at the front of the heart

Richard pascarella didn't know the technique used..only that he had an experienced surgeon who did the right thing with the right procedure.

Richard Pascarella: "Oh I'm perfect now."