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A coronary artery bypass graft performed “off-pump,” meaning a heart-lung machine is not used, may have a number of advantages, such as reducing the risk of plaque breaking off. Learn more about this procedure by watching this animation.
One less-invasive innovation in coronary artery bypass surgery is a procedure called off-pump bypass, or beating-heart surgery, because the operating team doesn't stop your heart and place you on a heart-lung machine. Instead, the surgeon uses special equipment to hold the heart steady, enabling him or her to operate while the heart continues to beat.
Early studies of the surgery suggested that off-pump bypass lowers the need for blood transfusions and leads to less short-term cognitive decline. But more recent evidence hasn't upheld the cognition advantage. And some data show that grafts placed during off-pump surgery are more likely to become blocked, which probably reflects the technical difficulty of sewing grafts onto a beating heart.
Over all, in terms of effectiveness and safety, off-pump and conventional bypass surgery seem to be equal. The risks for two of the biggest long-term complications of bypass surgery, cognitive problems and cardiac events (subsequent heart attack or the need for a follow-up procedure), are similar for off-pump and conventional surgery. For now, the skill of the surgeon and the quality of the hospital are more likely to affect the outcome than whether your surgery is performed on-pump or off-pump.
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