• Christoph Schmitz and Armin Welz.
• Department of Cardiac Surgery, University of Bonn, Bonn, Germany.
• Surg Technol Int. 2002 Sep 1; 10: 157-60.

AbstractDuring recent years, a rapid progress in the area of minimally invasive heart surgery has been seen. In addition to operations through smaller incisions and those without a complete median sternotomy, minimally invasive in cardiac surgery also means--and this might be even more important--performing the operation without cardiopulmonary bypass (CPB). Documented evidence indicates that CPB is an independent risk factor for end-organ injury after heart surgery. However, discussion continues regarding whether off-pump coronary artery bypass (OPCAB) techniques allow the same (or better) outcomes in long-term graft patency, myocardial damage, and associated morbidity compared with the classic operation done on CPB. That is one of the reasons the German insurance companies still do not accept OPCAB techniques as a viable alternative for surgical coronary revascularization, although the avoidance of CPB appears to have the greatest potential to minimize procedural costs and, consequently, provide economic benefit.

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