Besides traditional coronary artery bypass graft (CABG) surgery, there is a newer type of bypass surgery called off-pump bypass, or beating heart bypass surgery. Off-pump bypass allows the surgeon to sew the bypass graft into place without stopping the heart or using a heart-lung machine, both of which are required for traditional bypass.

With “beating heart” revascularization, the movement of the heart is minimized using heart stabilizers and positioners. These devices keep the targeted regions of the heart virtually motionless while the physician performs the bypass.

This off-pump method eliminates any risk of complications from use of the heart-lung machine (e.g., stroke, memory problems after surgery, or postpump syndrome). However, because most off-pump operations still use the traditional incision in the middle of the chest, patients may still require a longer recovery period than with less-invasive surgical approaches.

Endoscopic vein harvesting (EVH) may also be used with a less-invasive form of coronary artery surgery known as minimally invasive direct coronary artery bypass, or MIDCAB. During a MIDCAB procedure, the physician gains access to the patient’s heart through a smaller incision in the side of the chest. This form of surgery is limited to patients with fewer blockages. It may be performed with or without the heart-lung machine.