Off-pump coronary surgery: where do we stand in 2010?

In this review, we will highlight recent studies comparing off-pump coronary artery bypass surgery with traditional on-pump coronary artery bypass surgery.

Current literature comparing off-pump vs. on-pump coronary artery bypass has failed to demonstrate the superiority of one technique over the other. Small prospective randomized controlled trials continue to show equivalent in-hospital outcomes and continue to raise concerns about vein graft patency and completeness of revascularization. Larger observational analyses are better powered to statistically compare in-hospital outcomes in both low and high-risk patients and in general have shown more favorable in-hospital outcomes and equivalent long-term outcomes with off-pump compared with on-pump coronary artery bypass.

Off-pump coronary artery bypass continues to be a useful technique for coronary revascularization. The benefits of off-pump techniques may be more apparent for patients at high risk for complications associated with cardiopulmonary bypass and aortic manipulation.