Off-pump coronary artery bypass

Coronary artery bypass surgery without cardiopulmonary bypass (English: Off -pump Coronary Artery Bypass, OPCAB ) is a new, hitherto not generally established procedure for the surgical treatment of coronary heart disease.

Method

In contrast to classical coronary artery bypass surgery on the beating heart is waiving a heart -lung machine (HLM ) surgery. The heart is fixed in the area of the area of the bypass connection ( anastomosis ) and in the apex of the heart in the longitudinal axis by a stabilizer. So also side walls and rear wall of the heart are accessible. During the entire operation of the blood flow through tubes, which are inserted in the coronary vessels is to be supplied, to ensure in the coronary vessels.

Benefits

The installation of the heart-lung machine in the ascending aorta (main artery), there is a risk of detachment of calcification of the vessel wall, which then can cause a stroke. This risk is reduced.

HLM caused through contact with foreign surfaces in the body, a non-specific inflammatory reaction. By this reaction, it may under adverse conditions lead to a deterioration of organ function (lung, liver, kidney), but this is generally reversible and of minor importance.

Disadvantages

The procedure is technically demanding for the surgeon. Therefore, it is more use, if not all three coronary vessels must be provided with bypasses. In comparable patients, the results regarding death, heart attack and again necessary surgery are comparable to the conventional method.

Swell

• MediClin Heart Center Lahr / Baden: bypass surgery on the beating heart without a heart -lung machine ( OPCAB ) ( German, html ) 2009 Accessed on 28 March 2009..