Off-Pump Coronary Artery Bypass (OPCAB)
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Coronary artery bypass grafting (CABG) has conventionally been an operation that requires the use of the heart lung machine. For selected patients, surgeons have designed an innovative way to bypass blocked arteries on the heart without the use of the heart-lung machine ... this operation is called "off-pump coronary artery bypass grafting" or "OPCAB". Although indications for performing this procedure are more limited, and long-term results compared with conventional CABG are unknown, there are some patients who may benefit from this procedure.
The principals of OPCAB are in some ways similar to that of CABG ... namely, that an artery from behind the breast bone and/or veins from the legs are used to "bypass" blood around coronary artery blockages. OPCAB is different from CABG in that the heart-lung machine is not used ... this means that the special catheters and "cannulae" that are placed in and around the heart for a conventional CABG operation are not used ... the heart continues to pump blood to the rest of the body, and surgeons must operate on a "beating heart".
An advantage of OPCAB over conventional CABG is that it may eliminate some of the risks associated with using the heart-lung machine. In most patients these risks are very, very small ... but in some older patients with significant atherosclerotic disease of their aorta, poor kidney function, or significant lung disease ... these risks may be more considerable, and OPCAB might be a reasonable and safer approach than conventional CABG.
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