Off-pump surgery: A technique for heart surgery designed to avoid use of the heart-lung machine. The technique permits surgery on multiple vessels within the heart by mechanically stabilizing it. Off-pump surgery is minimally invasive, as compared to surgery on the heart-lung machine. The potential benefits include shorter hospital stay, less bleeding, less chance for infection, less risk of irregular heartbeats (arrhythmia), less trauma, shorter recovery time, and greater cost effectiveness.
Off-pump surgery was initially created to avoid brain injuries attributed to the pump. However, no differences have been found in the rate or extent of mental decline in people who had traditional on-pump surgery as compared to those who had no surgery at all. The mental decline observed after on-pump surgery may stem from arteriosclerosis blocking blood vessels that supply the brain.
The rate of grafts that are still patent (open) 3 months after surgery was found to be lower with off-pump surgery than with on-pump surgery (88% vs. 98%), according to a 2004 study. The lower graft-patency rate with off-pump surgery is a risk of off-pump CABG.