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Clogged arteries decrease the supply of oxygen to the heart. This causes pain in movement as well as weakness and impaired organ functioning. Bypass surgery involves the use of healthy leg or chest blood vessels to divert blood and reestablish normal flow through damaged or constricted blood vessels. Join us as we highlight the fundamentals of the types of bypass surgery, i.e. on-pump and off-pump CABG.
How and When On-Pump CABG Works in Practice?
So, how is on-pump bypass surgery performed? Let’s find out!
On-pump CABG involves briefly stopping the heart and pumping blood to the body with the help of a machine that delivers oxygen to the body. The machine maintains the circulation constant as the surgeon grafts new vessels without the heart movement interfering with stitch control or visual access.
This technique facilitates longer surgeries in which over two arteries are to be repaired or in which the structure is so complicated that it adds time to the surgery. Surgeons often choose this method for patients with diabetes, along with multi-vessel disease or highly calcified arteries that require longer repair time.
The heart-lung machine provides a clean field to work with, but it may lead to side effects in older adults or people with kidney issues. Some patients experience temporary confusion or slow recovery because of the way the machine interacts with the body during the operation.
How Off-Pump CABG Avoids the Machine?
In off-pump CABG, the heart continues to beat during surgery, and the surgeon stabilises one section at a time using manual or mechanical tools. Blood moves naturally during the entire procedure.
It helps to avoid the potential impact of mechanical circulation on the brain or immune response. This option reduces the risk of complications linked to machines and may help with faster discharge and less inflammation after surgery.
Where Off-Pump CABG May Be Suitable?
So, when is off-pump bypass recommended? Conventionally, off-pump CABG is often used for patients with mild disease or where only one or two vessels need to be grafted with minimal surgical time. It can help in people who have already had strokes or those who may not tolerate large fluid shifts or long anaesthesia periods. Patients with liver disease or poor kidney function may also be better suited to off-pump surgery when the risk needs to be minimised early.
Final Overview: What Both Procedures Aim to Solve
Both approaches aim to restore blood flow so the heart muscle can receive oxygen support during regular activity and post-surgical recovery periods. Neither method changes the purpose of the surgery, which is to reduce symptoms and protect the heart from long-term complications caused by low flow.
Choice depends on heart condition, overall health test results, and the surgeon’s ability to manage risk across different surgical pathways. Dr Gokhale heart specialist, performs both on-pump and off-pump CABG using detailed clinical evaluation to guide treatment that matches each patient’s recovery capacity and heart structure.