Difference Between On Pump and Off Pump Coronary Artery Bypass Grafting


Coronary artery bypass graft surgery (CABG) is a surgical procedure which is used to treat coronary artery disease. Coronary artery disease is narrowing of the coronary arteries which are the blood vessels that supply oxygen and nutrients to the heart muscle. This disease is caused by build-up of fatty material within the walls of the arteries. The buildup of fatty material narrows the arteries which limit the supply of the oxygen-rich blood to the heart muscles.

A healthy blood vessel from another part of the body is used to treat the blocked or narrowed arteries to bypass the blocked portion of the coronary artery. Grafts or blood vessels are used for the bypass procedure by taking a vein from the leg or the artery in the chest. One end of this graft is attached above the blocked end and other at the end of the blockage. Blood is then routed around, or bypassed where the blockages go through the new graft to reach the heart muscle. This is called coronary artery bypass surgery.


Difference Between On Pump and Off Pump CABG

There are 2 different methods for performing coronary artery bypass graft surgery. The traditional method which is on the pump and the newer method which is an off-pump method. The type of procedure used depends on the condition of the patient.

On-pump CABG


On-pump coronary artery bypass graft surgery is a time-honored surgical procedure which is performed while the heart is stopped. The blood supply is provided to the rest of the body when the heart is stopped for which the surgeons uses cardiopulmonary bypass machine. The artificial circulation system performs the function of the heart and the lungs. Cannulas are placed in the heart to drain the impure blood to the pump where it is purified and pumped back into the patient.

The heart can be safely stopped with the help of specialised medications which not only stops it but it also nourishes it when the heart is still. The bypass grafts are then constructed and at the end of the procedure and the heart is restarted. When the heart resumes it adequate function of the cardiopulmonary bypass machine which is disconnected and the pipes are withdrawn from the heart. On-pump coronary artery bypass graft surgery is a much safer procedure which has a small amount of risk and complications in it.

Off-Pump CABG

Coronary Artery Bypass Grafting 458

Off-Pump CABG is a newer method of performing CABG. The complications of on-pump CABG, especially stroke decreases in higher mental function, spurred the development of this technique.

Off-pump CABG procedure is performed when the heart is beating without the use of the heart-lung machine. In this procedure, the use of artificial circulation and placement of special pipes is eliminated.  This technique introduces a new complexity of attaching grafts to the heart while it is constantly moving and filled with blood. Special devices are used to mechanically stabilise the relevant part of the heart so that the suturing can be performed on a relatively immobile platform.

Poor grafting technique can result from constant motion which can jeopardize the quality of these grafts. Off-pump is a highly specialised procedure which is to be performed by experienced surgeons with good results. Off-pump CABG is a newer technique with the proposed benefit of lower complication rates.

Affordable CABG Surgery in India

CABG is quite an expensive surgery in western countries whereas in India this surgery is available at the most affordable costs. Medical facilities in India are available at the most affordable costs. The success rate of CABG surgery in India is very high due to the availability of the best cardiac surgeons and healthcare facilities. Patients from different countries come to India and undergo successful CABG surgery at the most affordable costs.



One thought on “Difference Between On Pump and Off Pump Coronary Artery Bypass Grafting

  1. Thanks for sharing, that was an informative read, especially the OFF pump technique. If you are interested, check out my medical blog and do not hesitate to follow my blog for new updates, and I did write about CABG too!


    Liked by 1 person

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