Beating heart surgery is a way to perform surgery without stopping the heart. Surgeons use a special device to stabilize the part of the heart on which they are operating. The heart continues to beat and circulate blood to heart muscle during the operation. Surgery on a beating-heart helps reduce the risk for complications associated with temporarily stopping the heart during surgery. Surgery on a stopped heart is common, and some heart procedures can only be performed on a motionless heart. Physicians use a special solution called cardioplegia to stop the heart. If the heart is stopped for surgery, the surgeon must restart it and reintroduce blood into the tissue. This is called reperfusion. Reperfusion can cause impairment of heart function. Sometimes, heart muscle tissue can be damaged at the cellular level during reperfusion, a phenomenon known as reperfusion injury. In some people, reperfusion injury can lead to complications such as arrhythmias and heart attacks. Reperfusion injury is especially a concern in high-risk patients, such as the elderly, people who have had several heart surgeries, patients with severe blockages, and those with complex health problems. Reperfusion injury can be avoided if the heart is kept beating during surgery.
Advantages of beating-heart surgery

• Better preservation of heart function.
• Better survival rate, especially among high-risk patients.
• Reduced hospital stay.
• Quicker recovery.
• Less chance for heart rhythm, kidney, or liver complications.
• Reduced risk for neurological injury, including stroke and memory complications.

Beating Heart Bypass Surgery is different from traditional bypass surgery because it is performed while your heart is still beating. Your surgeon does not use the heart-lung machine to stop your heart during the procedure. In some cases, the surgeon may still need to use the heart-lung machine during the operation. A perfusionist (a specialist trained to operate the heart-lung machine) may remain on standby during your operation. With this approach, surgeons can perform multiple bypass grafts on all areas of the heart, including the backside (posterior), at the same time. What this means is, the surgeon can perform a triple (three bypass grafts), quadruple (four bypass grafts) or more through a middle of the chest incision all off-pump.