Glowing heart with healthy arteries.

Heart Health Breakthrough: Can Off-Pump Bypass Surgery Help Those With Weak Hearts?

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Discover how a modified heart surgery technique is giving new hope to patients with severe heart failure."

For individuals grappling with severe left ventricular (LV) dysfunction, a condition where the heart struggles to pump blood effectively, coronary artery bypass surgery presents a significant challenge. But, the evolution of surgical methods, particularly the rise of off-pump coronary artery bypass (OPCAB) surgery, offers a beacon of hope.

OPCAB has emerged as a compelling alternative to traditional bypass surgery, which relies on cardiopulmonary bypass machines. OPCAB allows surgeons to operate on a beating heart, reducing the risks associated with stopping and restarting the heart. Furthermore, studies suggest that using bilateral internal thoracic arterial grafts, which utilize arteries from the chest wall, provides superior long-term outcomes compared to single grafts.

Although OPCAB with bilateral internal thoracic arterial grafting shows promise for patients, understanding the specific outcomes remains crucial. This article will explore how patients with severe left ventricular dysfunction fare with this innovative surgical approach, comparing their results to those with better heart function.

OPCAB: A Promising Option for LV Dysfunction?

A study published in the Journal of Korean Medical Science, explored the outcomes of OPCAB with composite bilateral internal thoracic artery grafting in patients with varying degrees of left ventricular function. The researchers aimed to determine if this approach could effectively improve outcomes for those with severely compromised hearts.

The study, conducted at Samsung Medical Center in Seoul, Korea, retrospectively reviewed data from 1,842 patients who underwent primary isolated OPCAB with composite bilateral internal thoracic artery grafting between January 2001 and December 2008. Of these patients, 131 had severely depressed left ventricle ejection fraction (LVEF ≤ 0.35), while the rest had mild to moderate LVEF (0.36-0.59) or normal LVEF (> 0.6). The study compared the outcomes across these groups.

Patient Population: The study included a diverse group of patients undergoing OPCAB, allowing for a comparison of outcomes based on the severity of LV dysfunction.
Surgical Technique: All patients received composite bilateral internal thoracic artery grafts, a technique known for its potential long-term benefits.
Outcome Measures: The study analyzed early and late mortality, cardiac events, and changes in left ventricular function to assess the effectiveness of OPCAB in different patient subgroups.

The study revealed that the early mortality rate for patients with severe LVEF was 2.3%. While this may seem concerning, the 3-year and 7-year survival rates were encouraging, at 86.0% and 82.8%, respectively. However, multivariate analysis indicated that severe LV dysfunction was associated with a two-fold increase in the risk of mortality compared to patients with normal LVEF.

The Future of Heart Surgery

While the study highlights the potential benefits of OPCAB in patients with severe LV dysfunction, it also underscores the increased risk associated with this condition. Further research is needed to refine surgical techniques and identify strategies to mitigate these risks, ultimately improving long-term outcomes for individuals with weakened hearts. The findings suggest that OPCAB with bilateral internal thoracic artery grafting can be a valuable option, but careful patient selection and management are crucial.

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This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3346/jkms.2014.29.1.69, Alternate LINK

Title: Outcomes Of Off-Pump Coronary Bypass Grafting With The Bilateral Internal Thoracic Artery For Left Ventricular Dysfunction

Subject: General Medicine

Journal: Journal of Korean Medical Science

Publisher: Korean Academy of Medical Sciences

Authors: Suryeun Chung, Wook Sung Kim, Dong Seop Jeong, Jaejin Lee, Young Tak Lee

Published: 2014-01-01

Everything You Need To Know

What is Off-Pump Coronary Artery Bypass (OPCAB) surgery, and how does it differ from traditional bypass surgery?

Off-Pump Coronary Artery Bypass (OPCAB) surgery is a surgical technique where the coronary artery bypass is performed on a beating heart, without the use of a cardiopulmonary bypass machine. In contrast, traditional bypass surgery involves stopping the heart and using a cardiopulmonary bypass machine to take over the heart's function during the procedure. This difference is significant because avoiding the heart-lung machine in OPCAB can reduce the risks associated with stopping and restarting the heart, potentially leading to better outcomes for patients.

How does severe Left Ventricular (LV) dysfunction impact the success of Off-Pump Coronary Artery Bypass (OPCAB) surgery?

Severe Left Ventricular (LV) dysfunction, where the heart struggles to pump blood effectively, presents a greater challenge in OPCAB surgery. Research indicates that patients with severe LV dysfunction (LVEF ≤ 0.35) undergoing OPCAB have an increased risk of mortality compared to those with normal LVEF (> 0.6). While OPCAB offers a promising alternative, the study shows that severe LV dysfunction is associated with a two-fold increase in the risk of mortality. This highlights the importance of careful patient selection and management in these cases.

What are the benefits of using bilateral internal thoracic arterial grafts in Off-Pump Coronary Artery Bypass (OPCAB) surgery?

Bilateral internal thoracic arterial grafts involve using arteries from the chest wall to bypass blocked coronary arteries. Studies suggest that these grafts provide superior long-term outcomes compared to single grafts. In the context of OPCAB, using bilateral internal thoracic arterial grafts is a technique that is known for its potential long-term benefits, contributing to improved patient survival and reduced cardiac events. This approach offers a durable solution for restoring blood flow to the heart muscle, enhancing overall heart health.

What were the key findings regarding mortality rates in the study on Off-Pump Coronary Artery Bypass (OPCAB) surgery for patients with severe Left Ventricular (LV) dysfunction?

The study revealed that the early mortality rate for patients with severe Left Ventricular (LV) dysfunction undergoing Off-Pump Coronary Artery Bypass (OPCAB) was 2.3%. Although there is a mortality risk, the 3-year and 7-year survival rates were encouraging, at 86.0% and 82.8%, respectively. However, multivariate analysis showed that severe LV dysfunction was associated with a higher risk of mortality compared to patients with normal LVEF. These findings suggest that while OPCAB is a valuable option, patients with severe LV dysfunction require careful monitoring and management due to the elevated risks.

What further research is needed to improve outcomes for patients with severe Left Ventricular (LV) dysfunction undergoing Off-Pump Coronary Artery Bypass (OPCAB) surgery?

Further research is needed to refine surgical techniques and identify strategies to mitigate the risks associated with severe Left Ventricular (LV) dysfunction in patients undergoing Off-Pump Coronary Artery Bypass (OPCAB) surgery. This includes exploring ways to improve patient selection, optimize surgical approaches, and enhance postoperative care. Such research aims to improve the long-term outcomes for individuals with weakened hearts, ensuring that OPCAB with bilateral internal thoracic artery grafting remains a valuable and safe option. This will involve identifying and addressing the factors that contribute to the increased mortality risk in these patients, to increase the overall success of the procedure.