[Myocardial protection during coronary artery bypass surgery while off-pump]

Abstract

Myocardial protection during off-pump coronary artery bypass surgery (OPCAB) is a multifactorial problem and choice of graft sequence, maintenance of stable systemic hemodynamics are of central importance. New devices for atraumatic stabilization of the heart and visualization of coronary anastomoses allow grafting of all coronary arteries without cardiopulmonary bypass. Perfusion-assisted direct coronary artery bypass (PADCAB) techniques, in which coronary perfusion is independent of systemic arterial pressure, can eliminate unstable hemodynamic and improve myocardial protection during complex, multivessel OPCAB.