There is an important advantage in doing a complete operation off-pump in a patient with multivessel disease. When you give the protamine, you immediately get the gel, or the fibrin deposition, and there is almost no bleeding at all. As a result, the chest tubes that we usually place for post-operative drainage can be discontinued. This allows the patients to get up and walk around and take care of themselves. Oh, much less.
Mortality is higher in on-pump surgery.
Well, that is a question. Off-pump surgery is suited for the patient with multiple risk factors. If a patient has had a previous stroke, if he is elderly, or if he has calcification of the aorta, then doing bypass on that patient can increase morbidity and mortality. However, if you approach that patient through an off-pump technique, avoiding these partial occlusion clamps on the aorta, aortic manipulation, and bypass, then you can get tremendous dividends. Yes, they do, although it happens less frequently.