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OPCAB The right procedure for the right patient

Supporting your choice of surgical therapies for your patients with coronary artery disease (CAD).

OPCAB keeps hearts beating

Since 1997, more than 2 million hearts kept beating during cardiac surgery because of off-pump coronary artery bypass (OPCAB). OPCAB is a coronary artery revascularization that is performed on a beating heart. Many cardiac surgeons have chosen OPCAB over conventional arrested heart surgery for its many clinical benefits for eligible patients.

Clinical benefits

OPCAB has been clinically shown to be less invasive than conventional arrested-heart surgery. This technique, which reduces many of the negative effects associated with going on-pump, can be accomplished with the Medtronic Octopus™ technologies, which have enabled many cardiac surgeons to perform more OPCAB procedures.

  • Offers a safe alternative to on-pump CABG1
  • Provides an effective option for high-risk patients and women2,3
  • Diminishes the need for inotropes and blood products1,4
  • Reduces the incidence of atrial fibrillation5
  • ISMICS Consensus Statement indicates that complete revascularization and equivalent patency rates are possible for OPCAB procedures1
  • Enables a decreased incidence of intraoperative aortic dissection (IAD) after open heart surgery when a no-touch aortic technique is used6

Patient selection criteria

The OPCAB procedure is effective for many cardiac patients, but not all. Clinical data suggests OPCAB may be an effective alternative for high-risk patients and women.2

Prior to the introduction of cardiopulmonary (CPB), it was common for cardiac surgeons to perform CABG procedures on a beating heart. However, the emergence of CPB and methods of myocardial protection revolutionized CABG procedures by providing a bloodless, motionless heart. While CPB is still the gold standard for many patients, studies suggest performing beating heart surgery to treat coronary artery disease may provide superior outcomes in certain patient populations.2

Our technologies enable direct visualization

More than 20 years ago, when we introduced the Octopus™ tissue stabilizers for OPCAB, it changed the way cardiac surgeons could perform beating heart surgeries. For the first time, epicardial tissue could be stabilized using vacuum-assisted technology, making direct visualization possible, and completing anastomoses easier. Today, tissue stabilizers are seen as standard for beating heart therapies.

We continue to offer the innovative technologies that help you perform OPCAB procedures. These include the Medtronic Octopus™ Evolution AS tissue stabilizer and Starfish™ Evo heart positioner, and OctoBase™ sternal retractor. These devices are shown here as positioned in the chest during an OPCAB procedure.

Octopus™ Evolution AS tissue stabilizer, Starfish™ Evo heart positioner, and OctoBase™ sternal retractor placed for OPCAB

Octopus Evolution AS tissue stabilizer for OPCAB procedures

New ways of working together

Off-pump coronary artery bypass (OPCAB) procedures are becoming more mainstream today. As the patient population changes, so do the demands on you, the cardiac surgeon. That’s why Medtronic is committed to supporting OPCAB. Together — with your skilled knowledge and our enabling technologies — we can deliver the right therapies for each individual patient with coronary artery disease (CAD).

Learn new beating heart skills and gain hands-on experience with technologies that may be new to you. We offer a full range of training programs. Contact us to learn more.



Puskas J, Cheng D, Knight J, et al. Off-pump versus conventional coronary artery bypass grafting: a meta-analysis and consensus statement from the 2004 ISMICS Consensus Conference. Innovations (Phila). Fall 2005;1(1):3–27.


Puskas J, Thourani V, Kilgo P, et al. Off-pump coronary artery bypass disproportionately benefits high-risk patients. Ann Thorac Surg. October 2009;88(4):1142–1147.


Mack MJ, Brown P, Houser F, et al. On-pump versus off-pump coronary artery bypass surgery in a matched sample outcome of women. A comparison of outcomes. Circulation. September 14, 2004;110(11 Suppl 1):II1–6.


Reston JT, Tregear SJ, Turkelson CM. Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting. Ann Thorac Surg. November 2003;76(5):1510–1515.


Cheng DC, Bainbridge D, Martin JE, Novick RJ. The Evidence-based Perioperative Outcomes Research Group. Does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials. Anesthesiology. January 2005;102(1):188–203.


Singh A, Mehta Y. Intraoperative aortic dissection. Ann Card Anaesth. Oct-Dec 2015;18(4):537–542.

Key risks

Patients undergoing an off-pump coronary artery bypass grafting procedure are at risk of the following, not inclusive: stroke, myocardial infarction, renal failure, infection, need for transfusion, and death.

Key risks of Octopus™ tissue stabilizers include: hematoma, laceration, ischemia, EKG/ECG changes, and abrasion.

Key risks of Starfish™ heart positioners include: tissue damage, infection, dissection, ischemia, laceration, and organ dysfunction.

Key risks of the Octobase™ sternal retractor include: laceration and infection.

Important safety information

Not all patients are candidates for beating heart procedures. Some patients would require cardiopulmonary support during surgery. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For a listing of indications, contraindications, precautions, and warnings, please refer to the Instructions for Use.