Off-bypass procedures have been regaining popularity as cardiac surgeons attempt to decrease the risks of surgical revascularization. In this article, the authors provide an overview of the adverse effects of cardiopulmonary bypass, a review of the literature in which the outcomes and on- and off-bypass procedures are compared, and a discussion of nursing implications related to this emerging new trend.

Many critical care nurses in current practice are unaware that surgical coronary revascularization, in its infancy, was first performed on a beating heart. The majority of the literature credits Kolessov,11 from the former Soviet Union, with performing the initial off-bypass surgery in 1964, when he reported his experience in anastomosing the internal mammary artery to the left anterior descending artery on a beating heart. Later in the United States, Favaloro22 (in 1968) and Garrett et...

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