Stay off-pump and do not touch the aorta! - Figure 1
Standard coronary artery bypass procedure requires aortic cannulation and clamping. Both manoevrescan cause emboli especially in the setting of an atherosclerotic aorta (A). For off-pump coronary artery bypass grafting (B), the target vessel is exposed applying a vacuum-assisted stabiliser that allows for local immobilisation (B). Cardiopulmonatry bypass is not required since the procedure is performed on the beating heart.
Appropriate myocardial revascularization: a joint viewpoint from an interventional cardiologist and a cardiac surgeon -Figure 1
Anatomical representation of stenting (left) and aorto-coronary bypass (right).
Coronary artery bypass grafting: Part 1—the evolution over the first 50 years
Experimental surgery for coronary artery disease that preceded the introduction of coronary artery bypass grafting. Different surgical methods have been applied: (A) ligation of the right internal mammary artery to increase blood flow to the coronary circuit through collaterals, (B) pericardial abrasion with the use of irritants to form adhesions, and (C) suturing different tissues to the myocardium as collaterals.
The ESC Textbook of Cardiovascular Medicine - Cover Illustration