Off Pump CABG Concomitant Another Organ Malignancy and Intra Operative Fibrillation Without Converting to on Pump CABG

Converting a procedure from off-pump coronary artery bypass grafting (CABG) to on-pump CABG involves transitioning from performing the surgery without the use of a heart-lung machine to performing the surgery with the assistance of a heart-lung machine. This decision is typically made during the surgery based on the surgeon's judgment and the patient's specific needs.

Here's an overview of the process involved in converting from off-pump CABG to on-pump CABG:

Evaluation and decision: During the off-pump CABG procedure, if the surgeon encounters complications or challenges that make it difficult to continue without the support of a heart-lung machine, they may decide to convert to on-pump CABG. Some situations that may warrant conversion include excessive bleeding, inadequate visualization, hemodynamic instability, or difficulty in performing the grafting procedure on a particular coronary artery.Preparation: Once the decision to convert is made, the surgical team will prepare for the transition. This involves establishing a sterile field and ensuring the necessary equipment, including the heart-lung machine, is ready for use.Cannulation and connection to the heart-lung machine: Cannulation involves the insertion of tubes or catheters into the patient's blood vessels. The surgeon will cannulate the aorta and the right atrium or the superior and inferior vena cava to establish connections with the heart-lung machine. Once the cannulation is completed, the patient's blood will be diverted through the machine, which will temporarily take over the functions of the heart and lungs.Cardiopulmonary bypass: With the patient connected to the heart-lung machine, the surgeon can proceed with the on-pump CABG procedure. The heart-lung machine will oxygenate and circulate the blood while maintaining appropriate blood pressure and flow throughout the body. This allows the surgeon to stabilize the heart, arrest its activity, and perform the necessary grafting procedure on the blocked coronary arteries.Completion of the procedure: After the grafts are successfully placed and the required surgical repairs are made, the surgeon will gradually wean the patient off the heart-lung machine. The connections to the machine will be removed, and the patient's heart will regain its normal function. The surgeon will ensure proper hemostasis (control of bleeding) before closing the incisions.It's important to note that the decision to convert from off-pump CABG to on-pump CABG is made in the best interest of the patient's safety and the successful completion of the procedure. The surgeon's experience and judgment play a crucial role in making this decision during the surgery.