 One of the most controversial areas of cardiac surgery has been whether off-pump coronary artery bypass grafting OPCAB surgery is superior to conventional on-pump coronary artery bypass grafting CABG surgery. There is an ongoing debate about the benefits and disadvantages of OPCAB. Initial trials have shown that off-pump CABG is feasible in selected low-risk patients and offers results similar to those of CABG performed with the conventional on-pump technique on-pump CABG1,2. In institutions with experience in off-pump CABG, the rates of major adverse events and of complete revascularization and graft patency have been similar to those with on-pump CABG3. 