OPCAB was performed before the advent of heart lung machine. But with the development of stabilizers, coronary artery bypass grafting has been performed over the last two decades successfully in many centres around the world. But still 80% of bypass surgeries are done on the heart lung machine. We were one of the few teams who have been performing this OPCAB for the past 18 years. All along, we have been innovating, fabricating and developing and patenting instruments, techniques and technology to help us perform OPCAB in 100% of all our coronary patients. That too being able to reduce the mortality of bypass surgery to less than 0.5%. In this chapter, we have attempted to write down our strategy, in order to successfully perform OPCAB in all our patients, so that the coming generation can benefit from it.
Coronary artery bypass grafting (CABG), has evolved over the last twenty-five years. Having pioneered this evolution for the last two decades and more, we have moved from an on-pump surgical unit to a completely off-pump surgical unit. This on-pump surgery was in vogue for the past six decades. This was labeled the Conventional CABG (CCAB). We have over the last two decades made off-pump coronary artery bypass (OPCAB) the new CCAB. To make this a reality, we had to invent, innovate, fabricate and modify techniques and technology, so as to make ourselves comfortable to perform all our CABGs without the use of the Heart-lung machine (HLM). We have over the last twenty years performed more than five thousand OPCAB surgeries in this city alone, with a mortality of less than 1%.
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