Which CABG alternative is performed without cardiopulmonary bypass and on a beating heart?

Which CABG alternative is performed without cardiopulmonary bypass and on a beating heart?

• A. Minimally invasive coronary artery bypass (MIDCAB)
• B. Robotic heart surgery
• C. Conventional on-pump CABG with CPB
• D. Off-pump coronary artery bypass (OPCAB)

Answer: (D)

Off-pump coronary artery bypass grafting involves performing grafts on a beating heart without using a cardiopulmonary bypass machine. Surgeons place epicardial stabilizers to immobilize the exact area of the heart being grafted while the rest of the heart continues to beat and the native circulation persists. Because CPB isn’t used, there’s no cardioplegic arrest, though the procedure requires careful handling to maintain stability and perfusion; if the heart becomes unstable, conversion to on-pump may be needed. This set-up contrasts with conventional on-pump CABG, where the heart is stopped and CPB takes over circulation. Some minimally invasive or robotic approaches can also be off-pump, but the defining feature here is performing CABG on a beating heart without CPB.

Off-pump coronary artery bypass grafting involves performing grafts on a beating heart without using a cardiopulmonary bypass machine. Surgeons place epicardial stabilizers to immobilize the exact area of the heart being grafted while the rest of the heart continues to beat and the native circulation persists. Because CPB isn’t used, there’s no cardioplegic arrest, though the procedure requires careful handling to maintain stability and perfusion; if the heart becomes unstable, conversion to on-pump may be needed. This set-up contrasts with conventional on-pump CABG, where the heart is stopped and CPB takes over circulation. Some minimally invasive or robotic approaches can also be off-pump, but the defining feature here is performing CABG on a beating heart without CPB.