Coronary artery bypass surgery cardiopulmonary bypass

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Synonyms and keywords:


There are alternative operative strategies such as off-pump or beating heart, which have their own risks and benefits. These alternatives could be used when the risks of aortic manipulation outweigh the safe use of a cross-clamp or cannulation of the ascending aorta. Furthermore, surgeon experience with the strategies mentioned above should be considered.

Cardiopulmonary Bypass in CABG Patients

2021 ACA Revascularization Guideline

Class 2a Recommendation, Level of Evidence: B-R [1][13][2]
When significant calcification of the aorta is present, usage of techniques such as off-pump techniques or beating heart (to avoid aortic manipulation) is rational to reduce the perioperative stroke incidence when performed by experienced surgeons.
Class 2b Recommendation, Level of Evidence: B-R [1][2][9][10][11][12]
Utilizing off-pump surgery could be rational for patients with significant pulmonary disease in order to decrease perioperative risk when performed by experienced surgeons.


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