Background: Before the advent of CABG, standardized in the late '60s by Favaloro and
Effler, patients with myocardial ischemia underwent indirect and heterogeneous off-pump methods
of myocardial revascularization.
Methods & Results: Indirect revascularization, such as periaortic nerve plexus interruption, Vineberg
operation, Sen procedure and, less remotely, TMR Laser and stem cell transplantation, represented
some of the ways to achieve myocardial revascularization. Nowadays, direct coronary revascularization
is the only established technique and may be performed either on-pump or off-pump.
Conclusion: The comparison of off-pump and on-pump myocardial revascularization paved the way
to an endless debate between the advantages and disadvantages of each technique. In this article, we
review the old and current off-pump approaches of surgical myocardial revascularization.