Coronary artery bypass surgery or CABG or bypass surgery as it is known more commonly is the most commonly performed heart operation world-wide with more than 10 million procedures performed annually. During the initial phase (20th century) the CABG was performed on heart & lung machine the whole blood was drained into this machine and the heart was stopped before performing the surgery. This required a lot of manipulation of the heart & clamping of the Aorta which led to a dreaded complication known as CVA or stroke in which one side of the body was paralysed. The incidence of stroke was in the range of 2-4% in On-pump CABG era. Later (21st century), with the advancement of technology the surgeons started doing CABG without the help of Heart lung machine, commonly known as beating heart bypass surgery. In this technique the heart kept on beating while the surgeon was performing the procedure. The incidence of major complications including stroke was drastically reduced. However, in order to perform the proximal anastomosis the surgeon must partially clamp the Aorta, so the chances of stroke are still present in the range of 1.5-2% Currently, we perform CABG in which there is no need to clamp the Aorta, both the internal thoracic arteries from inside the chest are used to bypass all the major coronary arteries. It is a technically challenging operation with huge long term benefits for the patient including a dismal stroke rate (<0.5%) and a long term relief from coronary artery disease.  This procedure is known as An-aortic or “No touch aortic” total arterial bypass surgery.

Avoidance of aortic manipulation in An-OPCAB decrease the risk of postoperative stroke. In addition, the elimination of cardiopulmonary bypass reduces the risk of short term mortality, renal failure, bleeding, atrial fibrillation and the length of ICU stay.

An-OPCAB is currently suitable for every patient undergoing bypass surgery, however we can surely tell after examining the patient and reviewing his angiogram.

Yes, the An-OPCAB package is slightly expensive than CABG package, however if we look at the huge long term benefits of An-OPCAB it is negligible.