In an off-pump coronary artery bypass, or OPCAB procedure, the bypass will be created while the heart is still beating by using stabilizers that allow areas being worked on to be still. The potential advantage is avoiding possible complications and side effects attributed to the heart-lung machine.
In either on- or off-pump surgery, one end of the graft is stitched to an opening below the blockage in the coronary artery. If the grafted vessel is the saphenous vein or the radial artery, its other end is stitched to an opening made in the aorta. If the grafted vessel is the mammary artery, its other end stays connected to the patient’s circulation.
The entire surgery can take 4-6 hours. After the surgery, you will be taken to the Intensive Care Unit. For a few days after the surgery, you will be connected to monitors and tubes.
This illustration of a heart with grafting shows one saphenous vein (from the leg) and one internal mammary artery graft (from the chest).