The History of Off-Pump Coronary Bypass (OPCAB)

Despite Alexis Carrel early description of experimental coronary artery bypass graft, 1 surgeons were unable to translate these techniques successfully to humans due to a lack of technology and tools to operate on the unsupported beating heart. In 1952, Demikhov described the use of the LITA to directly graft the left anterior descending in dogs, with graft patency confirmed for up to 2-years. 2 Similar early success with the use of the ITA was reported by Canadian surgeon Gordon Murray. Willian Longmire was apparently the first surgeon in performing an Off-pump coronary artery bypass operation. He said they performed a couple of the earliest internal mammary coronary anastomosis when they were forced into it when the coronary artery they were endarterectomizing disintegrated and in the desperation they anastomoses the left internal mammary artery to the distal end of the right coronary artery.