US Market Report for Off-Pump Coronary Artery Bypass Devices 2018 - MedCore
OPCAB procedures are much harder to perform because the beating heart adds difficulty in performing a bypass on the posterior and lateral walls of the heart. Surgeons have found many ways to stabilize the heart to bypass the necessary arteries. Most commonly, stabilizer and positioner devices are used in surgeries to aid physicians in stabilizing and positioning the heart and arteries.
Off-pump coronary artery bypass (OPCAB), or simply beating-heart coronary artery bypass grafting, utilizes a medial sternotomy to access the heart, similarly to on-pump coronary artery bypass (ONCAB) procedures. The important difference is that the cardiopulmonary bypass pump is not employed. Clinical studies show that OPCAB offers several benefits compared to ONCAB procedures, including reductions in bleeding, decreases in short-term neurocognitive dysfunction, kidney dysfunction and length of hospital stay. Despite these advantages, the inherent technical challenges of performing OPCAB have impeded its widespread adoption. These off-pump procedures require special techniques and instrumentation in order to perform efficient and reliable anastomosis on the beating heart. The increasing penetration of anastomosis assist devices (AAD) has helped to create precise and reliable anastomoses and slow the decline in OPCAB procedure volume. It should be noted that all minimally invasive coronary artery bypass graft (CABG) procedures, including minimally invasive direct coronary artery bypass (MIDCAB) and totally endoscopic coronary artery bypass (TECAB), are performed off-pump. These procedures differ from traditional OPCAB techniques in that they do not require a highly invasive medial sternotomy.