Name: CABG anaesthesia: on-pump and off-pump — viva
Creator: MedVellum
Published: 2026-07-10
Keywords: CABG anaesthesia: on-pump and off-pump — viva, Vivas, Cardiac anaesthesia, ANZCA, FRCA, EDAIC, ABA, FCAI, ANZCA exam prep, anaesthesia fellowship, primary FANZCA, final FANZCA

Prompt

Cardiac theatre stem focusing on cabg anaesthesia: on-pump and off-pump with a monitoring printout and TOE still available.

Opening

One-line answer: On-pump CABG uses full heparinisation (300 IU/kg surveyed modal, ACT 400 or 480 s), CPB, and cardioplegic arrest; OPCAB avoids CPB but challenges the anaesthetist with heart displacement, regional ischaemia, and rapid conversion readiness.^[4]^[5]

References8Show

[1]Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery. N Engl J Med, 2017.PMID 29130845
[2]Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr, 2013.PMID 23998692
[3]Levy JH, Ghadimi K, Kizhakkedathu JN, Iba T What's fishy about protamine? Clinical use, adverse reactions, and potential alternatives. J Thromb Haemost, 2023.PMID 37062523
[4]Pereira RM, Guerra N, Ferreira R, et al. Contemporary Clinical Practices in Anticoagulation Management During Cardiopulmonary Bypass: A Europe-Wide Survey. Interdiscip Cardiovasc Thorac Surg, 2026.PMID 41787968
[5]Chassot PG, van der Linden P, Zaugg M, et al. Off-pump coronary artery bypass surgery: physiology and anaesthetic management. Br J Anaesth, 2004.PMID 14970136
[6]Shim JK, Kim KS, Couture P, et al. Hemodynamic management during off-pump coronary artery bypass surgery: a narrative review of proper targets for safe execution and troubleshooting. Korean J Anesthesiol, 2023.PMID 36824043
[7]Paparella D, Brister SJ, Buchanan MR Coagulation disorders of cardiopulmonary bypass: a review. Intensive Care Med, 2004.PMID 15278267
[8]Engelman DT, Ben Ali W, Williams JB, et al. Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations. JAMA Surg, 2019.PMID 31054241

Opening

References8Show

[1]Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery. N Engl J Med, 2017.PMID 29130845
[2]Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr, 2013.PMID 23998692
[3]Levy JH, Ghadimi K, Kizhakkedathu JN, Iba T What's fishy about protamine? Clinical use, adverse reactions, and potential alternatives. J Thromb Haemost, 2023.PMID 37062523
[4]Pereira RM, Guerra N, Ferreira R, et al. Contemporary Clinical Practices in Anticoagulation Management During Cardiopulmonary Bypass: A Europe-Wide Survey. Interdiscip Cardiovasc Thorac Surg, 2026.PMID 41787968
[5]Chassot PG, van der Linden P, Zaugg M, et al. Off-pump coronary artery bypass surgery: physiology and anaesthetic management. Br J Anaesth, 2004.PMID 14970136
[6]Shim JK, Kim KS, Couture P, et al. Hemodynamic management during off-pump coronary artery bypass surgery: a narrative review of proper targets for safe execution and troubleshooting. Korean J Anesthesiol, 2023.PMID 36824043
[7]Paparella D, Brister SJ, Buchanan MR Coagulation disorders of cardiopulmonary bypass: a review. Intensive Care Med, 2004.PMID 15278267
[8]Engelman DT, Ben Ali W, Williams JB, et al. Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations. JAMA Surg, 2019.PMID 31054241