TY - CHAP M1 - Book, Section TI - Off-Pump Coronary Artery Bypass A1 - Peck, Eric A. A1 - Sergeant, Paul A2 - Yuh, David D. A2 - Vricella, Luca A. A2 - Yang, Stephen C. A2 - Doty, John R. PY - 2014 T2 - Johns Hopkins Textbook of Cardiothoracic Surgery AB - Team approachAlthough all cardiac operations require a multidisciplinary approach, this is especially true for off-pump coronary artery bypass grafting (CABG). Close and clear communication with the anesthesiologist is critical for the safe performance of the procedure. Similarly, the nursing staff should be included in the dialogue so that it can anticipate each step in the operation and prepare instruments, shunts, and sutures as necessary and in a timely fashion.Minimization of riskOff-pump CABG has the potential to reduce morbidity and mortality significantly. However, if done improperly, it can lead to higher complication rates. This is best avoided by minimizing potential intraoperative risk at every possible step.ReengineeringTo achieve optimal results with this technique, it must be realized that this procedure is not just a CABG performed without the assistance of cardiopulmonary bypass. Instead, it requires a complete reengineering of the operative technique and physiologic concepts, including optimizing oxygen supply and demand and maintaining hemodynamic stability before, during, and after cardiac manipulation. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1104589024 ER -