What is Off-Pump Coronary Artery Bypass Surgery?

Your physician may recommend heart bypass surgery, if you have clogged coronary (heart) arteries. The standard surgery for this condition requires a heart bypass machine (your heart is stopped during surgery). If you are older or have complex medical problems, it may be too risky for you to have heart surgery with a bypass machine.

Baptist Health offers a newer procedure called OP-CAB, or off-pump coronary artery bypass. This procedure combines traditional heart surgery with new technology that doesn't require a heart bypass machine.

• Smaller sized incision during surgery—A smaller incision means less impact to your body during and after surgery.
• Smaller sized scar after surgery—A smaller scar is less noticeable and less cosmetically problematic.

Who Should Get an OP-CAB?

If you experience severe coronary artery disease, your doctor will usually recommend OP-CAB surgery. While the OP-CAB surgery procedure is effective, each person responds differently to it. If your coronary artery disease is not severe, your doctor may suggest alternative treatments such as medicine or lifestyle changes. Another nonsurgical option is angioplasty, or coronary stenting.

Before Surgery

Before OP-CAB surgery, your doctor will typically suggest how to prepare for the procedure. This involves reducing or stopping smoking, stopping certain medication, and not drinking or eating anything the night before your surgery.

Your doctor may also perform pre-surgery exams. Possible exams include a chest X-ray, blood tests, and evaluations of your heart. For example, your doctor might use an electrocardiogram (EKG) to check the rhythm of your heart. Your doctor might also conduct cardiac stress testing to assess blow flow.

During Surgery

During OP-CAB heart surgery, your medical team will administer aesthesia to place you in a deep state of unconsciousness. Therefore, you will not feel any pain or regain awareness until the operation is complete. You can expect the surgery to last for several hours.

While you sleep, your surgeon will make a cut in your body, usually on your leg or chest. Then the surgeon will remove a blood vessel through the incision. If your surgeon has not already done so, they will make a cut on your chest to open it for the rest of the procedure. Next, your surgeon will bypass the blockage in your coronary artery using the blood vessel they removed earlier in the operation. Your surgeon will then connect one end of the removed blood vessel to your aorta and the other end to your coronary artery.

After Surgery

There are a few things you can expect to happen immediately after OP-CAB cardiac surgery. For example, you can expect to wake up in a recovery room several hours after the procedure. 

What to expect after OP-CAB surgery:

• You might initially feel confused about where you are and what is happening.
• Your medical team will monitor your heart rate and other vital signs.
• A tube might be inserted in your throat for up to 24 hours. The tube helps you breathe.
• You may notice a tube inserted in your chest to drain extra fluid.
• You will likely feel some discomfort and soreness. However, you should not feel extreme pain.
• Often, you can drink the day after your procedure.
• You can eat as soon as your body can tolerate regular food.
• Within two days, you can typically walk or sit upright in a chair with assistance.
• You can expect your hospital stay to last for up to five days.

Leaving the Hospital

Your doctor will let you know what to expect once you are released to go home. We recommend following your doctor’s suggestions to avoid complications after off-pump coronary artery bypass surgery.

What to expect once you leave the hospital:

• Your doctor will usually advise you to schedule someone to transport you from the hospital to your home.
• Your stitches or staples will be removed in approximately seven to ten days.
• You may feel fatigued for a few weeks.
• You may need assistance with driving until your doctor clears you to drive yourself.
• Your doctor may prescribe medications.
• Your doctor might recommend changes to your diet.
• Your doctor will likely suggest exercise routines.
• Your doctor may suggest how to care for your wounds.
• You will usually need to avoid lifting heavy objects for a few weeks.
• Your doctor may refer you to a cardiac rehab program.

Complications

There are several possible complications with an off-pump CAB procedure. The specific risks depend on your general health, your age, the severity of your condition, and how well you respond to surgery. The risks with OP-CAB are lower than the risk with CAB using a heart-lung machine.

Off-pump coronary artery bypass risks:

• Bleeding
• Blood clots
• Infection
• Abnormal heart rhythms
• Kidney failure
• Anesthesia complications