Af ternoon heart surgery ‘is 50% more successful’

HEART surgery is 50% more successful if it is done in the afternoon, a major study has found.

Experts believe this is because the heart is better at repairing itself later in the day.

The human body clock – known as the ‘circadian rhythm’ – is still adjusting from the sleep stage to the awake stage in the morning, but by the afternoon, it is better equipped to deal with a traumatic event such as open-heart surgery.

The researchers, whose work is published in the respected Lancet medical journal, called for hospitals to move operations to the afternoon in light of the findings.

Study leader Professor David Montaigne, of the University of Lille in France, said: ‘Our study found that post-surgery heart damage is more common among people who have heart surgery in the morning, compared to the afternoon.

He added: ‘As a result, moving heart surgery to the afternoon may help to reduce a person’s risk of heart damage after surgery.’

Researchers tracked 596 people who had undergone heart valve replacement surgery; half of them had the operation in the morning, the other half in the afternoon.

Over the next 500 days, those who had the operation in the afternoon were 50% less likely to experience a major cardiac event than those who had surgery in the morning. The researchers calculated that for every 11 patients who have surgery in the afternoon, one potentially catastrophic incident would be avoided.

In a second part of the study, they examined another 88 patients, and found those who had afternoon surgery had lower levels of heart tissue damage.

Experts last night welcomed the findings – but stressed that more evidence was needed before hospitals should change their practices.

Dr Mike Knapton, of the British Heart Foundation, said: ‘Thousands of people now have openheart surgery in the UK. These procedures can take many hours and come with a number of risks.

‘The time of day appears to be a significant factor in the outcome from surgery... If this finding can be replicated in other hospitals, this could be helpful to surgeons planning their operating list.’

Graham Cooper, president of the Society for Cardiothoracic Surgery in Great Britain and Ireland, said: ‘In the UK, surgeons tend to operate on the sickest patients in the morning, meaning we might expect them to have very slightly worse outcomes.’