Current status of coronary artery bypass grafting

The number of coronary artery bypass grafting (CABG) has reached more than 21,000 cases per year in Japan, and the operative mortality has decreased less than 1% including emergent operation. There are 2 trends in CABG. One is the revival and wide spread of off-pump CABG (OPCAB). The other is multiple arterial coronary revascularization. In 2004 and 2005, 60% of all CABG procedures in Japan were performed without cardiopulmonary bypass. For competition with percutaneous coronary intervention with drug eluting stents and better long-term outcomes, CABG with only arterial grafts was carried out in 52% of total cases and 66% of OPCAB cases. OPCAB with multiple arterial grafts has been becoming the standard CABG in Japan. We reviewed OPCAB and arterial CABG including new technology.