Strong Heart and Vascular Center
Division of Cardiac Surgery
Off-pump Coronary Revascularization Surgery
Typically, when a patient undergoes open-heart surgery, it is necessary to stop the patient's heart and maintain the body's circulation through the use of cardioplumonary bypass (CPB), also called the heart-lung machine. This procedure is commonplace, and quite safe, although there is growing concern about associated risks, such as inflammation, stroke and neurological complications.
In recent years, an alternative procedure has been developed called off-pump coronary revascularization, or off-pump bypass surgery. In an off-pump bypass, the heart continues to beat and just the portion of the heart being operated on is stabilized during the surgery. Since the heart continues beating, circulation is maintained without the use of the heart-lung machine (therefore - "off-pump").
At this time, use of the heart-lung machine remains standard procedure, but there is mounting evidence that off-pump bypass surgery may result in fewer complications. At the Strong Heart and Vascular Center, about 50% of our CABG procedures are performed off-pump.
If you are facing open-heart surgery, you will want to discuss with your doctor the best option for you.
Our surgeons who perform off-pump Coronary Revascularization Surgery
Precautions We Take With Off-pump Coronary Bypass Surgery
At the Strong Heart and Vascular Center, our expertly trained open heart surgery team includes cardiovascular anesthesiologists, nurses and surgical assistants. A perfusionist is available and on stand-by if the use of the heart-lung machine becomes necessary.
For the procedure, we make the incision through the standard median sternotomy (the breastbone split). This gives us access to all areas of the heart, and makes it easy if we need to use the CPB. The procedure is considered minimally invasive, based upon the reduced trauma to the patient.
Benefits of Off-pump
Compared to traditional CABG, off-pump CABG may reduce some complications and improves outcomes in high risk patients.
High risk patients who benefit most from off-pump coronary revascularization include people: