Off-pump coronary artery bypass is a form of coronary artery bypass surgery (CABG) performed without cardiopulmonary bypass (heart-lung machine) as a treatment for coronary heart disease.

Off-pump coronary artery bypass was developed partly to avoid the complications of cardiopulmonary bypass during cardiac surgery. The medical community believed cardiopulmonary bypass caused a post-operative cognitive decline known as postperfusion syndrome (informally called “pumphead”), but research has shown no long-term difference between on and off pump coronary artery bypass.^[1]

Off-pump surgery is associated with less blood transfusions, but is more technically challenging. The technique has a steep learning curve, and the quality of the anastomoses is lower, at least until a surgeon has gained much experience. Off-pump surgery remains a useful technique for some more complicated cases, such as people whose aorta is calcified.

• Cardiac surgeon
• Coronary artery bypass surgery (CABG)
• Minimally invasive direct coronary artery bypass surgery (MIDCAB)
• Percutaneous coronary intervention (PCI), a.k.a. angioplasty

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