Kamales Kumar Saha
CABG without Pump and Clamp! Is It Better or Worse?
Benefits of off-pump coronary artery bypass grafting in reducing complications of coronary artery bypass grafting are well established in literature. Moreover avoiding aortic manipulation and using bilateral internal thoracic artery during off-pump coronary artery bypass grafting has the advantage of improving long-term outcome and reducing stroke incidence. In spite of compelling evidence, OPCAB is poorly adopted by the skeptics. Contemporary evidences of grafts patency, completeness of revascularization and survival after on and off-pump coronary artery bypass grafting are discussed in this review. Similar internal thoracic artery patency rate in Danish off-pump versus on-pump randomized study suggest both techniques are comparable. Various factors affecting graft patency after coronary artery bypass grafting were discussed. Anaortic off-pump coronary artery bypass grafting has the added advantage of reducing the incidence of stroke and can be the best surgical alternative to percutaneous coronary intervention.
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