Current Readings on Off-Pump Coronary Artery Bypass

Historically, the use of cardiopulmonary bypass (CPB) in performing coronary artery bypass grafting (CABG) has been the “gold standard” in coronary revascularization. However, with greater understanding of the inflammatory effects of CPB and the increased risks of strokes in atherosclerotic or calcified aortas, there has been a growing interest in less-invasive approaches to the standard conventional technique. One such approach is performing coronary revascularization without using CPB, also known as off-pump CABG (OPCAB). Several studies have reported that OPCAB is a safe and effective technique that avoids the significant morbidity associated with the use of CPB, whereas other studies report no overall advantage with the avoidance of CPB in coronary revascularization and a trend toward better outcomes in patients undergoing the conventional on-pump technique. The controversial topic of on-pump vs OPCAB has been the subject of ongoing debate for over a decade. This article reviews current literature and hopefully provides an unbiased guide for assessing the values, benefits, and risks of both the techniques.