Off-Pump Coronary Artery Bypass Surgery

Coronary artery bypass surgery, also called coronary artery bypass graft (CABG), is used to route blood around hardened or narrowed portions of the coronary artery (coronary artery disease) to improve oxygen-rich blood supply to the heart muscle.

During coronary artery bypass surgery, an incision is made down the center of the chest and through the sternum (median sternotomy) to allow the surgeon to visualize and access the narrowed coronary artery. A section of healthy blood vessel taken from the chest, arms or legs is then sewed onto the coronary artery (“grafted”) above the blockage and reattached below to allow blood to “bypass” the blockage and provide greater blood supply to the heart muscle.

In traditional coronary artery bypass surgery, the heart is stopped and the patient is placed on a heart-lung machine to allow the surgeon to perform the graft on the stilled heart. In recent years, an “off-pump” technique has become more common. In the off-pump procedure, the surgeon performs the graft on the beating heart by “stabilizing” the portion of the heart where the operation is being performed.

The off-pump procedure reduces the risk of complications that may occur with the use of the heart-lung machine, including heart damage, excessive blood loss, renal (kidney) complications and an increased risk for post-operative stroke. Because of this, the off-pump procedure is especially appropriate for elderly patients and patients that are too ill to undergo the stress of stopping the heart and using a heart-lung machine.

Emory has performed more off-pump coronary artery bypass procedures than any other hospital system in the US. In fact, more than 80% of coronary artery bypass procedures at Emory are performed off pump, compared with a national average of less than 25%. In addition to the surgical off-pump procedure, Emory also offers a minimally invasive off-pump procedure for select patients.