Disadavantages and technical limitations of off-pump coronary artery bypass surgery
| Technical issues | Proposed solutions |
|---|---|
| Motion of the heart | Pharmacologic or mechanical stabilisation |
| Tempory interruption of coronary flow | Luminal shunt during construction of anastomosis |
| Arteriotomy seal | |
| Distal perfusion cannula | |
| Blood flow in arteriotomy | Temporary luminal shunt |
| Saline infusion | |
| Carbon dioxide gas blower | |
| Pressure drop | Trendelenburg, inotropic support, fluid |
| Limited space for: | Miniaturisation of instruments |
| preparation of mammary artery | Endoscopic video assisted surgery |
| identification of coronary artery | |
| construction of anastomosis | |