Dr. Craig Smith - What Is an Off-Pump Coronary Artery Bypass Surgery?

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An Off-pump Coronary Artery Bypass procedure or OPCAB as it's known for Off-pump Coronary Artery Bypass is a way of doing coronary artery surgery bypassing coronary obstructions without stopping the heart and without using the heart lung machine. In the history of the treatement of coronary artery disease, in the first few years, some of it was done in a beating heart.

As we learned how to stop the heart, that became simpler, and was by far the most preferable, and most commonly done way to bypass obstructive coronaries. Off-pump bypass developed in the late 1990s and a little bit after that, and has become important in a segment of the population, and in a segment of surgeons.

About 25% of the coronary surgeries that's done in the US is done off-pump. The majority is still done on-pump. There's a long debate about the relative virtues of each which gets somewhat technical, but each has its role.