Anaesthesia for off-pump coronary artery surgery.

O coronary artery bypass (OPCAB) is a technique of performing coronary anastomosis on a beating heart without instituting cardiopulmonary bypass (CPB). Coronary stabilizers (CS) are used for local cardiac wall immobilization and access to the heart can be achieved by a lateral, anterolateral, subxyphoidal or midsternal incision. With median sternotomy and use of CS, all sides of the heart can be reached, thus enabling triple vessel revascularization on the beating heart. Therefore, techniques such as minimally invasive direct coronary artery bypass grafting (MIDCAB), which allows only single or two vessel surgery have slowly phased out.