Question

Describe the on-pump coronary artery bypass procedure. How does it differ from an off- pump coronary...

Describe the on-pump coronary artery bypass procedure. How does it differ from an off-
pump coronary artery bypass procedure? What are the risks associated with an on-pump
procedure? Why is there a greater incidence of complications in an on-pump versus off-
pump procedure?

Homework Answers

Answer #1

Coronary Artery Bypass Surgery is a surgery used to improve the blood flow to the heart by redirecting the blood around a blocked or a partially blocked artery in the heart. CABG is performed by 2 different methods, On-pump CABG and Off-pump CABG.

An on-pump CABG procedure is the one in which the heart is stopped and the blood supply to the rest of the body is provided by a cardiopulmonary bypass machine, that provides artificial circulation. It is a more traditional way of performing CABG. The impure blood is drained to the pump or the cardiopulmonary bypass machine with the help of cannulas placed in the heart, where it is purified and pure blood is pumped back to the body. The heart is stopped with specialized medications which also nourishes it when still. The graft procedure is then performed by sewing one end of the blood vessel to a tiny opening made in the aorta and the other end is sewed to an opening made in the blocked coronary vessel. After completion of the grafting, the cardiopulmonary bypass machine is disconnected and the cannulas are removed from the heart, and the heart is restarted.

Risks: The patient’s comorbidity increases the risk of the procedure.

Other complications include: Post-operative Stroke

Kidney or liver failure

Bleeding

Delirium.

The other method to perform CABG is Off-pump, which is a newer technique. In this method, the procedure is performed while the heart is beating and without using the cardiopulmonary bypass machine. This means the heart continues to work and pump blood to the other parts of the body during the procedure. This technique the surgeon grafts the blood vessel on the pumping heart while the area around the blocked coronary artery is stabilized. Special devices are used to stabilize the relevant part of the heart to ensure effective suturing.

Out of the 2 techniques, On-pump CABG procedure is consider more safe as it has shown excellent results with vert low mortality and morbidity.

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