Graft–Coronary Anastomosis in Off-Pump CABG
Coronary artery bypass grafting (CABG) is a surgical procedure whereby an anastomosis is formed between a graft and the coronary artery. The graft patency rate is one of the most important factors affecting long-term postoperative prognosis.
Among the many factors affecting graft patency, the most important is reliable skill in performing an anastomosis. The basic points requiring caution in performing a graft–coronary artery anastomosis are the same whether it is performed on-pump or off-pump. Surgeons must be aware, however, that there are a number of intrinsic differences when forming the anastomosis. These differences are the reason for the high degree of difficulty of off-pump anastomosis. However, by performing a large number of on-pump anastomoses, as well as accumulating experience in off-pump anastomoses, surgeons may acquire the ability to perform anastomoses of any region of the coronary artery off-pump as accurately as they would on-pump.