Off-pump coronary artery bypass surgery

Associate Editor-In-Chief: Mohammed A. Sbeih, M.D.[mailto:msbeih@perfuse.org] Phone:617-849-2629 ,

Overview
Off-pump coronary artery bypass is a form of coronary artery bypass surgery (CABG) performed without cardiopulmonary bypass (heart-lung machine) as a treatment for coronary heart disease.

Off-pump coronary artery bypass was developed partly to avoid the complications of cardiopulmonary bypass during cardiac surgery. The medical community believed cardiopulmonary bypass caused a post-operative cognitive decline known as postperfusion syndrome (informally called "pumphead"), but research has shown no long-term difference between on and off pump coronary artery bypass.

Off-pump surgery is associated with less blood transfusions, but is more technically challenging. The technique has a steep learning curve, and the quality of the anastomoses is lower, at least until a surgeon has gained much experience. Off-pump surgery remains a useful technique for some more complicated cases, such as people whose aorta is calcified.