Abstract
The development of on-pump, i, e. under extracorporeal circulation, coronary artery bypass grafting (CABG) was established by improvement of the surgical technique, medical equipment and myocardial protection during cardioplegic arrest, and has shown sufficiently satisfactory results. However, complicated preoperative characteristics and coronary lesions require further improvement of surgical techniques. Against such background, various methods have been sought at each institution to improve the off-pump beating heart CABG method performed under severely limited indications since 1995. Based on the improvement in clinical results for severely. 11 patients, extension of the indications for off-pump CABG has been a Hempted and there has been some improvement in graft harvesting techniques and surgical instruments as a result. The presence of extracorporeal circulation is the most important factor generating complications in the perioperative period, the new management for postoperative atrial fibrillation is required for off-pump CABG strategies. Finally it is considered that a change in the surgical procedure from on-pump to off-pump would be able to contribute to medical economy by providing less invasive treatment to the patient without decreasing the quality of the results.
