Off Pump Coronary Artery Bypass Surgery
Heart Stabilizer used in
Off Pump Coronary Surgery
Heart Stailizer and Coronary Bypass
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Dr. Ramchandani specializes in "off pump" coronary artery bypass surgery, also referred to as "beating heart" surgery. Thousands of people around the world have been successfully treated for coronary artery disease with this new type of surgery.
"Off pump" or "beating heart" bypass surgery may also be referred to as OPCAB (an acronym for "Off Pump Coronary Artery Bypass").
The procedure eliminates the use of the heart-lung machine (or "pump") during coronary artery bypass (CABG) surgery. In other words, the surgery is performed on a beating heart. The surgeon enters the chest cavity through the sternum (the chest), similar to traditional bypass surgery.
With this approach, surgeons can perform multiple bypass grafts on all areas of the heart, including the backside (posterior), at the same time. What this means is, the surgeon can perform a triple (three bypass grafts), quadruple (four bypass grafts) or more through a middle of the chest incision - all off-pump! |
The goal of any bypass surgery is to increase coronary artery blood flow to your heart and ultimatately improve your life. A bypass operation may actually include two surgical procedures. In the first operation, the surgeon will use healthy blood vessels to "bypass" the blocked arteries in the heart.
The second procedure is the removal (or "harvesting") of a healthy blood vessel, usually from the leg, to construct the bypass grafts. Recent advances in medical technology make it possible to perform the second procedure in a different way, through very small incisions using an "endoscopic" technique. |
Endoscopic Vein Harvesting
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What is Beating Heart Bypass Surgery?
Recent advances in surgery and medical devices allow doctors to have less invasive options in the treatment of coronary artery disease, such as beating heart bypass surgery. Individuals who have medical conditions such as diabetes, history of stroke or poor physical health, can now undergo cardiac surgery with fewer risks for complications a decreased risk for developing complications related to the heart-lung machine. You will want to talk with your doctor to see if beating heart bypass surgery is an option for you.
Heart and Stabilizer
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Beating heart bypass surgery is different from traditional bypass surgery because it is performed while your heart is still beating. Your surgeon does not use the heart-lung machine to stop your heart during the procedure. In some cases, the surgeon may still need to use the heart-lung machine during the operation. A perfusionist (a specialist trained to operate the heart-lung machine) may remain on standby during your operation.
Benefits of beating heart bypass procedure include:
- Quicker recovery
- Decreased length of hospital stay
- Less trauma due to the elimination of the heart-lung machine
- Reduced risk of bleeding, stroke and kidney failure
- Fewer cognitive and neurological consequences, such as stroke
- Reduced psychomotor and cognitive problems
- Reduced post-operative complications
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Reduced Blood Loss and Fewer Transfusions
Clinical studies have consistently demonstrated that OPCAB is an effective technique for significantly reducing the blood loss and transfusion requirements often associated with CPB.1,3,4,5,12,15,18,21,22,23 In two prospective, randomized studies by Puskas et al. and Ascione et al., the number of OPCAB patients requiring transfusions was(more)
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Options in Off-Pump Bypass Surgery
Currently there are two techniques available in off-pump coronary artery bypass (CABG) surgery. During both procedures, the patient's heart continues to beat and the surgeon uses special instruments to stabilize the heart, allowing the surgeon to sew the bypass graft on a moving field (while the heart is beating).
Mid-Sternal Incision |
The OPCAB approach is performed through a mid-sternal incision. The procedure your surgeon uses depends on the number and location of the coronary vessels that need to be bypassed.
Individuals that have medical conditions such as diabetes, history of stroke or poor physical health, can now undergo cardiac surgery with a decreased risk for developing complications related to the heart-lung machine. You will want to talk with your doctor to see if beating heart (or off-pump) bypass surgery is an option for you. |
This copy is intended to provide you and your family a better understanding of coronary artery disease, beating heart bypass surgery and endoscopic vessel harvesting. It is not intended as a substitute for an informed discussion with your physician. If you have questions after reading this booklet, please write them down so your physician or other healthcare professionals can answer them for you. Not everyone may be a candidate for these alternative approaches to cardiac surgery however we hope you will discuss these options with your physician.
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