• S Hariharan, D Chen, and L Merritt-Charles.
• Anaesthesia and Intensive Care Unit, The University of the West Indies, Eric Williams Medical Sciences Complex, Mt Hope, Trinidad and Tobago, West Indies. uwi.hariharan@gmail.com
• W Indian Med J. 2006 Oct 1;55(5):298-304.

ObjectivesTo review the evolution of off-pump coronary artery bypass surgery with particular reference to the anaesthetic and perioperative implications.FindingsAfter review of the literature regarding coronary artery bypass grafting, the adverse effects of cardiopulmonary bypass on the various systems are discussed The development and the present status of off-pump coronary artery bypass surgery and its anaesthetic implications are reviewed These are discussed under the categories of preoperative, intra-operative and postoperative concerns. In Trinidad and Tobago, various cardiac surgical teams from different parts of the world conduct cardiac surgery. The cardiac anaesthesia team therefore has the unique opportunity of working with several teams who employ different techniques.ConclusionsOff-pump coronary artery bypass grafting surgery has distinct anaesthetic implications. In Trinidad and Tobago, the majority (85%) of the coronary revascularization surgeries are being done by this technique. Because of the lower cost and improved outcomes, this technique could be recommended to other developing countries of the region.

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