Off-Pump Coronary Artery Bypass Surgery: Current Status

Coronary revascularization was first performed on the beating heart. Later on the heart-lung machine facilitated the wide-spread application and allowed accurate anastomoses to be performed on a fibrillating or arrested heart. The contemporary beating heart surgery goes back to the original approach, thereby using appropriate technology and techniques that have allowed surgeons to perform high quality reproducible anastomoses. Beating heart surgery has once again established its place as an acceptable method for multi-vessel coronary revascularization. Worldwide, approximately 30% of all surgical coronary revascularization procedures are performed on a beating heart (off-pump coronary artery bypass-OPCAB); in some countries they exceed 50%, while in some centers they even approach 99% of unselected cases. Several end-points have been analyzed from recent publications of the world literature, and are presented herein.