Off-Pump Coronary Artery Bypass (OPCAB) Surgery

Abstract

Off-pump coronary artery bypass grafting is a type of open-heart surgery whereby coronary grafts are performed without the use of cardiopulmonary bypass (CPB) and cardioplegia. Although not performed as frequently as on-pump coronary artery bypass grafting, it is still utilized in certain situations. Because CPB is not used, anesthetic management has many unique considerations, including temperature management and anticoagulation. Proper monitoring of cardiac output, mixed venous oxygen saturation, and wall motion abnormalities via transesophageal echocardiography are very important during intraoperative management, and there are many anesthetic and surgical techniques that are utilized to limit the degree of myocardial ischemia during surgical construction of the coronary anastomoses.