Why OPCAB is used
Coronary artery bypass surgery typically requires cardiopulmonary bypass that involves circulating the blood through a pump and arresting the heart while the surgeon bypasses the diseased vessels. Off-pump bypass surgery (OPCAB) is defined as revascularization surgery performed under direct visualization via a median sternotomy incision without utilization of coronary bypass. While the results of traditional cardiac artery bypass have improved dramatically over the years, some of the most persistent, common and significant complications related to heart arrest and cardiopulmonary bypass persist. These include:
- Postoperative stroke
- Myocardial dysfunction
- Kidney failure
Bleeding and diffuse inflammatory response due to complement activation
Surgeons have therefore focused on techniques that might obviate the need for CPB during coronary revascularization. With recent advances in technology and instrumentation, the practice of grafting coronary arteries off pump has grown in acceptance.