Off-Pump Coronary Artery Bypass (OPCAB)

Abstract

Abstract Off-pump coronary artery bypass graft surgery (OPCAB) is an alternative to standard coronary artery bypass graft (CABG) surgery. This procedure is performed similarly to CABG and involves one or more coronary arteries bypassed via a midline sternotomy approach. OPCAB has the advantage of avoiding the complications of cardiopulmonary bypass (CPB), such as coagulopathy, the inflammatory response, and manipulation of the aorta. Compared to the use of CPB, the lack of optimal surgical conditions and increased hemodynamic instability with OPCAB are challenges the surgeon and anesthesiologist will face. The anesthesiologist must be prepared to handle patient hemodynamic instability during OPCAB, which is different from full hemodynamic support provided during CPB.