MINIMALLY INVASIVE CARDIAC
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
OFF Pump CABG (OPCAB) -
correct answer ✅•Attempted in 1950
•Became popular in 1990 with the advancement of retractors and
epicardial stabilizers (Octopus)
•Also called "beating heart bypass"
•Typically performed with full median sternotomy, no CPB, can use
a limited anterior thoracotomy approach (MIDCAB)
•Should always have perfusionist on standby for all OPCABs
•Our focus is more important than routine CABG on pump
OFF Pump CABG (OPCAB) -
correct answer ✅•Accounts for approx. 20-30% of all CABGs
,MINIMALLY INVASIVE CARDIAC
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
•Performed to avoid the complications of CPB (pump and aortic
clamping
•Surgical manipulation of the heart has significant effects on CV
system
•Two independent variables: (a)distortion of left and right atrium
and ventricles by stabilizer and suspension devices (b) effects of
myocardial ischemia induced by vessel occlusion during
anastomosis
•Communication with surgical team/surgeon is critical
Octopus Coronary Vessel Stabilizer -
correct answer ✅Can apply suction or CO2 through these tubes to
see the artery better
Suction is applies to this tubing so heart can be lifted up
,MINIMALLY INVASIVE CARDIAC
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
Benefits of OPCAB -
correct answer ✅•Decrease incidence of AF
•Decrease transfusions
•Decrease respiratory infections
•Decrease need for inotropes
•Decrease ventilation time
•Decrease hospital stay
•Less renal dysfunction
•Less short-term neurocognitive dysfunction
, MINIMALLY INVASIVE CARDIAC
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
•Long term graft patency remains an issue. Research is
controversial
OFF Pump CABG (OPCAB) -
correct answer ✅•Verticalization- lift of the heart to work on
posterior vessels (PDA, CX)
•Displacement- lateral movement of the heart to work on LAD and
diagonal vessels
•Pre-op assessment the same as on pump CABG
•A-line, PA cath. with EF <40%, abn. LV wall motion, LVEDP > 18,
recent MI or unstable angina, TEE, large bore IVs
•Monitor UOP, nasopharyngeal temp., or urine temp.,
•Patients with advanced age, ascending aortic disease, multiple
comorbidities are good candidates for OPCAB
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
OFF Pump CABG (OPCAB) -
correct answer ✅•Attempted in 1950
•Became popular in 1990 with the advancement of retractors and
epicardial stabilizers (Octopus)
•Also called "beating heart bypass"
•Typically performed with full median sternotomy, no CPB, can use
a limited anterior thoracotomy approach (MIDCAB)
•Should always have perfusionist on standby for all OPCABs
•Our focus is more important than routine CABG on pump
OFF Pump CABG (OPCAB) -
correct answer ✅•Accounts for approx. 20-30% of all CABGs
,MINIMALLY INVASIVE CARDIAC
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
•Performed to avoid the complications of CPB (pump and aortic
clamping
•Surgical manipulation of the heart has significant effects on CV
system
•Two independent variables: (a)distortion of left and right atrium
and ventricles by stabilizer and suspension devices (b) effects of
myocardial ischemia induced by vessel occlusion during
anastomosis
•Communication with surgical team/surgeon is critical
Octopus Coronary Vessel Stabilizer -
correct answer ✅Can apply suction or CO2 through these tubes to
see the artery better
Suction is applies to this tubing so heart can be lifted up
,MINIMALLY INVASIVE CARDIAC
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
Benefits of OPCAB -
correct answer ✅•Decrease incidence of AF
•Decrease transfusions
•Decrease respiratory infections
•Decrease need for inotropes
•Decrease ventilation time
•Decrease hospital stay
•Less renal dysfunction
•Less short-term neurocognitive dysfunction
, MINIMALLY INVASIVE CARDIAC
SURGERY, Off Pump CABG, and
Ablation Exam Questions With 100%
Verified Answers
•Long term graft patency remains an issue. Research is
controversial
OFF Pump CABG (OPCAB) -
correct answer ✅•Verticalization- lift of the heart to work on
posterior vessels (PDA, CX)
•Displacement- lateral movement of the heart to work on LAD and
diagonal vessels
•Pre-op assessment the same as on pump CABG
•A-line, PA cath. with EF <40%, abn. LV wall motion, LVEDP > 18,
recent MI or unstable angina, TEE, large bore IVs
•Monitor UOP, nasopharyngeal temp., or urine temp.,
•Patients with advanced age, ascending aortic disease, multiple
comorbidities are good candidates for OPCAB
