Complication rate
8.00%
Range 5.00–13.00%
n=1 study
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cardiology
Off-pump coronary artery bypass (OPCAB) is a CABG technique performed on a beating heart without cardiopulmonary bypass. The surgeon uses tissue stabilisers to immobilise the small area of the coronary artery being grafted while the rest of the heart continues to beat. OPCAB avoids the systemic inflammatory response and other physiological consequences of cardiopulmonary bypass, but is technically more demanding than on-pump CABG and may produce slightly fewer complete revascularisations in some hands. ACC/AHA guidelines recommend OPCAB as a reasonable alternative to on-pump CABG in selected patients, particularly those with calcified ascending aortas where aortic cannulation is high-risk.
Off-pump CABG was popularised in the 1990s and 2000s as a way to avoid the inflammatory and neurological consequences of cardiopulmonary bypass. The technique requires advanced stabilisation equipment, intracoronary shunts to maintain distal coronary flow during grafting, and considerable surgeon experience. Large randomised trials (ROOBY, CORONARY) have shown comparable mortality and major adverse cardiac event rates compared to on-pump CABG when performed by experienced operators, with some short-term advantages (stroke, transfusion) and the trade-off of slightly lower graft patency in some series.
Off-pump CABG pricing is typically equivalent to on-pump at the same centre — the operating room time and length of stay are similar, and the avoided cardiopulmonary bypass equipment is offset by specialised stabiliser cost. Total quoted prices cover surgeon's fee, anaesthetic fee, ICU and ward stay (typically 1-2 nights ICU + 3-5 nights step-down), all in-hospital medications, and immediate follow-up. Cardiac rehabilitation may be a separate cost.
Complication rate
8.00%
Range 5.00–13.00%
n=1 study
Revision rate
5.00%
Range 3.00–10.00%
n=2 studies
Mortality rate
1.50%
Range 0.50–3.00%
n=2 studies
Aggregated from peer-reviewed systematic reviews on PubMed. How we extract these rates.
Specialty-board certifications and facility-level accreditations relevant to this procedure. Verify on the issuer's public register before booking — most issuers publish a searchable directory.
National cardiothoracic-surgery board
Issuer Country-specific (e.g. ABTS in US, FRCS Cardiothoracic in UK, EBCTS in Europe)
Specialty-board certification in cardiothoracic surgery — required for any open-heart or coronary bypass operation.
Verify on the issuer's register →JCI hospital accreditation
Issuer Joint Commission International
Facility-level standards covering patient safety, infection control, governance, and clinical quality. Required by many medical-tourism intermediaries before listing a hospital.
Verify on the issuer's register →Average recovery for Off-Pump Coronary Artery Bypass (OPCAB) is 56 days. Individual recovery varies — always follow your surgeon’s specific guidance.
Immediate
First 24–48 hours post-procedure. Monitoring, anaesthesia recovery, initial pain management. Most clinics expect you to remain on-site or nearby.
Early recovery
Wound care, swelling or bruising peaks, restricted activity. Typical window for follow-up visits and drain removal if applicable. Travel is usually not advised.
Intermediate recovery
Gradual return to non-strenuous daily activity. Many international patients fly home during this window. Surgeon may require medical clearance for long-haul travel.
Full recovery
Return to full activity, exercise, and work. Final results may still be settling. Final follow-up with local doctor recommended.
Days 0-2: ICU recovery. Extubation typically within hours of OPCAB (faster than on-pump CABG in most series). Aggressive pulmonary toilet to prevent atelectasis. Pain control with regional and systemic analgesia.
Day 3-5: transfer to step-down ward. Mobilisation and chest physiotherapy. Daily review of cardiac rhythm; atrial fibrillation occurs in 20-30% of post-CABG patients and may be managed with rate or rhythm control.
Day 5-7: discharge to local accommodation. Continued mobilisation, regular wound checks, anticoagulant prophylaxis as indicated.
Week 2-3: outpatient cardiology and surgery review. Wound assessment, ECG, and bloods. Continued cardiac rehabilitation referral.
Week 4-6: gradual increase in activity. Walking to 30-45 minutes daily. Return to driving usually permitted at 6 weeks. Sternal precautions (no lifting >2-3kg, no pulling/pushing) continue.
Week 8-12: full sternal healing. Return to most normal activity. Cardiac rehabilitation continues. Lifelong cardiology follow-up begins for management of secondary prevention (aspirin, statin, blood pressure, lipid targets).
Off-pump CABG is offered at a smaller subset of cardiac centres because of the surgical expertise required. Patients considering OPCAB specifically should verify that the destination centre performs the technique routinely (typically >50 OPCAB cases per surgeon per year) and that the proposed surgeon is recognised in OPCAB outcomes data.
Long-haul flying after CABG (on-pump or off-pump) is typically not advised for 3-6 weeks per IATA medical guidance, longer for complex or complicated cases. International patients should plan for an extended in-country recovery and have a clear handover plan to home-country cardiology services for ongoing surveillance.
Bar length shows how many clinics in our registry offer off-pump coronary artery bypass (opcab) in each country. Shading shows the verification status mix. International price range is $22,000–$70,000 USD across all countries; we do not currently hold per-country clinic pricing suitable for side-by-side comparison.
Browse all destinations offering Off-Pump Coronary Artery Bypass (OPCAB)→
6 clinics in our registry
Verified
Accreditations, corporate registration, and published reviews independently checked against primary sources.
Partially verified
Some fields confirmed from primary sources; others self-reported by the clinic and awaiting verification.
Unverified
Listing is based on public information but has not yet been independently verified against primary sources.
Flagged
Credible concerns identified. Red flags are documented on the clinic page. We never soften or remove warnings.
Bangkok, Thailand·Est. 1980·Verified this week
Bumrungrad International Hospital is a multi-specialty private hospital in central Bangkok. Founded in 1980, it serves approximately 1.1 million patients annually, including over 520,000 international patients from 190 countries. The hospital is publicly traded on the Stock Exchange of Thailand.
Gurgaon, India·Est. 2001·Verified this week
A multi-specialty tertiary care hospital in Gurgaon (NCR Delhi) with JCI and NABH accreditation. Part of the Fortis Healthcare chain, which is publicly listed on the BSE and NSE. The cardiac surgery and orthopaedic departments serve a significant volume of international patients.
New Delhi, India·Est. 1996·Verified this week
A 710-bed tertiary care hospital in New Delhi and part of the Apollo Hospitals Group, one of Asia's largest healthcare chains. The hospital holds JCI, NABH, and NABL accreditations. Apollo is publicly listed on both the BSE and NSE. The hospital's international patient department handles visa assistance and travel coordination.
Seoul, South Korea·Est. 1994·Verified this week
A 1,979-bed tertiary hospital operated by the Samsung Medical Center Foundation, a subsidiary of Samsung Group. JCI-accredited since 2007. The hospital's international health services centre provides translation and coordination services in multiple languages.
Kuala Lumpur, Malaysia·Est. 2007·Verified this week
A 300-bed private hospital in central Kuala Lumpur owned by Petronas (Malaysia's national oil company). JCI-accredited since 2010. The hospital has a dedicated international patient centre and has been recognised multiple times by the Malaysia Healthcare Travel Council.
Istanbul, Turkey·Est. 2000·Verified this week
A JCI-accredited multi-specialty hospital in Istanbul’s Sisli district, part of the Memorial Healthcare Group. The hospital operates dedicated oncology, cardiac surgery, and orthopaedic departments serving international patients from the Middle East and Europe.
In experienced hands, mortality is comparable. OPCAB has short-term advantages (lower transfusion, possibly lower stroke rate, faster extubation) and the trade-off of slightly lower graft patency in some series and the surgical demand. ACC/AHA guidelines recommend OPCAB as reasonable in selected patients (Class IIa).
Patients with severely calcified ascending aortas (where aortic cannulation for on-pump bypass is high-risk) are the strongest candidates. Patients with significant comorbidity (renal dysfunction, advanced age, severe lung disease) may also benefit from avoiding cardiopulmonary bypass.
OPCAB has a meaningful learning curve. Surgeons with high OPCAB volumes (>50 cases per year) achieve outcomes comparable to on-pump CABG. Low-volume operators may have worse outcomes — both for completion of revascularisation and for major adverse events.
Conversion to on-pump CABG happens in 5-15% of OPCAB cases depending on patient anatomy and surgeon experience. Pre-operative consent should always cover the possibility of conversion. Outcomes after conversion are similar to planned on-pump CABG.
Yes — modern OPCAB technique allows multi-vessel revascularisation in most patients. The decision is based on coronary anatomy, target vessel quality, and surgeon experience. Some patterns (deep posterior targets, marginal target vessels) are technically more demanding off-pump.
Total length of stay is typically 5-7 days, similar to on-pump CABG. Extubation may be faster (4-6 hours vs 8-12 hours on-pump) and ICU stay slightly shorter, but step-down and ward time are comparable.
Combining off-pump CABG with valve replacement is technically possible but reduces the off-pump advantage substantially, because valve surgery typically requires cardiopulmonary bypass anyway. Most surgeons performing combined coronary-valve operations use on-pump CABG to maintain a consistent operative environment.
Extubation typically happens earlier (4-6 hours vs 8-12 hours on-pump) and ICU stay is slightly shorter, but total hospital length-of-stay is broadly similar — 5-7 days for most patients. The longer-term recovery trajectory (return to sedentary work, cardiac rehabilitation milestones) is comparable between on-pump and off-pump CABG.
Glossary entries associated with off-pump coronary artery bypass (opcab)
Off-Pump Coronary Artery Bypass (OPCAB) is a variant of Coronary Artery Bypass Graft (CABG). See the parent procedure for the broader category context.
Other cardiology procedures in our registry