Doctor’s Advice: The Advantage of Off-Pump Coronary Artery Bypass Graft Surgery (Off-Pump CABG)

In the past, heart or cardiac surgery required heart-lung bypass machine to divert blood vessels from the heart.  This process stops your heartbeat resulting in hypoxia and ischemia which affect the functioning of your lungs, kidneys and brain.  Today, there’s an Off – Pump Coronary Artery Bypass Grafting (Off-Pump CABG Off-Pump CABG).  This means the heart continues beating during surgery.  Therefore, it reduces the side effects that occur when the heart stops beating as well as helps patients return to a good quality of life faster.

The Advantages of Off-Pump CABG 

1. Reduced Mortality

The heart-lung machine that is used during heart surgery or cardiopulmonary bypass will stop the heartbeat and divert blood vessels into the machine which will oxygenate the body.  This will result in abnormal blood pressure, from a normal 120/70 down to merely 60-65.  Since using the heart-lung machine, the blood pressure is quite low during the surgery, it will affect the blood circulation in the brain and may cause stroke and paralysis in the elders and patients with cerebrovascular disease.  Therefore, Off-Pump CABG is essential for heart surgery.

2. Lesser Blood Loss

Whether it is the On-Pump CABG or Off-Pump CABG, it is necessary to inject Heparin to prevent blood clot during a surgery.  With Off-Pump CABG which does not require the heart-lung machine, heparin dosage will be 3 times less than with On-Pump CABG and blood loss is less than 70%.  So, there’s no need for blood transfusion during the surgery.

3. Faster Recovery

The Off-Pump CABG has fewer side effects than the On-Pump which requires the heart-lung machine.  The side effects of the latter include inflammation all over the body due to the reintroduction of extracorporeal blood oxygenation, excessive bleeding after surgery and longer recovery. Cardiac function may also decease post-surgery. Therefore, Off-Pump CABG that does not require the heart-lung machine will eliminate these risks and a ventilator can be removed immediately post-surgery in 80% of the cases. In contrast, patients who used On-Pump CABG will require a ventilator for at least 3 – 4 more hours. Removing the ventilator as soon as possible will reduce complications from other infections and the patient will recover faster because the internal organs will resume normal workload quicker, leading to overall return to normal everyday living.

There is no difference in long-term postoperative care between Off-Pump CABG and On-Pump CABG.  But the most important thing is to have the treatment with highly experienced specialists and a hospital equipped with holistic equipment.


For more information, please contact

Cardiothoracic Surgery Center
2nd Floor, Bangkok Heart Hospital.
Service Hours: Monday-Sunday 07.00 a.m. – 04.00 p.m.