Off-pump bypass surgery is a type of coronary artery bypass graft (CABG) surgery. It takes a blood vessel from one part of your body and uses it to bypass a blocked coronary artery. Unlike traditional CABG, off-pump surgery doesn’t stop your heart or use a heart-lung bypass machine. Instead, the surgeon stabilizes your beating heart during surgery.
Off-pump bypass surgery is a type of coronary artery bypass graft (CABG) surgery. CABG surgery takes an artery or vein from one part of your body (called a graft) and uses it to bypass a blocked coronary artery. The surgery restores normal blood flow to your heart.
During traditional CABG surgery, the surgeon stops the person’s heart. A cardiopulmonary bypass machine does the work of your heart and lungs throughout the surgery. The machine takes blood out of your body, adds oxygen, removes carbon dioxide, then puts oxygenated blood back into circulation.
But off-pump bypass surgery doesn’t use a heart-lung machine. Instead, the surgeon operates while your heart is still beating. It’s also called “beating heart” surgery.
Off-pump bypass surgery is a treatment option for coronary artery disease (CAD).
In a person with CAD, plaque builds up in the arteries, restricting or blocking blood flow. It can cause symptoms like chest pain and shortness of breath. A completely blocked artery can lead to a heart attack.
Severe cases of CAD that don’t respond to lifestyle changes, medications and other procedures may require bypass surgery. It can improve symptoms, reduce the risk of a heart attack and improve survival. Off-pump bypass surgery is an option for some people who choose CABG.
Bypass surgery takes several hours, depending on how many arteries are bypassed.
Your surgical team will give you instructions to help you prepare. Instructions may include:
Before off-pump surgery, your surgeon may order some tests to make sure you’re healthy enough for the operation:
Your surgeon will explain what to expect during off-pump bypass surgery. The team will:
After off-pump bypass surgery, you’ll be moved to a recovery room, where the surgical team will monitor you. You may:
Scientists are still studying the long-term benefits of off-pump surgery compared to on-pump surgery. Your surgeon will help you decide which is best for you.
On-pump CABG provides a surgical area that’s still and free of blood for better stability and visibility.
But off-pump bypass surgery may involve a smaller incision, shorter hospital stay and faster recovery. It may also reduce the risk of certain postsurgical complications:
It may be a better option for people with:
Not everyone is a candidate for off-pump bypass surgery. Some researchers believe that off-pump procedures might lead to the need for additional bypass surgeries in the future. And the procedure must be performed by a surgeon with experience in the approach.
Off-pump bypass surgery is a major operation. Although most people have a good outcome, there are some possible risks:
Recovery from off-pump bypass surgery depends on several factors, such as:
In general, you’ll:
You’ll have follow-up appointments with your healthcare provider during and after your recovery. But seek immediate medical attention if you experience:
A note from Cleveland Clinic
Off-pump bypass surgery is a type of coronary artery bypass graft (CABG) surgery. Unlike traditional CABG, the procedure doesn’t stop your heart or use a cardiopulmonary bypass machine. If you need CABG, talk to your healthcare provider about whether on-pump or off-pump surgery is best for you.
Last reviewed by a Cleveland Clinic medical professional on 05/02/2022.
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