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An alternative to traditional CABG is off-pump or beating heart surgery, where surgeons don't use the heart-lung machine. The procedure is also called OPCAB (Off-Pump Coronary Artery Bypass). The surgeons sew the bypasses onto the heart while it continues beating. Various types of heart stabilizers are used to restrain the heart one section at a time so the surgeon can operate on it. The chest is opened through a midline sternotomy incision. After the target coronary vessel is exposed and stabilized, it is occluded and opened. A bridging plastic tube -- which allows blood flow during suturing -- may be placed. The bypass graft is then sutured to the coronary artery.
The potential benefits/advantages of off-pump surgery may include the following:
High-risk patients with additional diseases like lung disease, kidney failure and peripheral vascular disease may benefit from this kind of operation. The University of Maryland offers OPCAB primarily to these patients.