The Center for Minimally Invasive and Robotic Heart Surgery has performed m
ore than 1,500 off-pump coronary artery bypass (OPCAB) procedures since 199
5. The operation has changed significantly based on experience and developm
ent of new tools. These improvements have made the operations safer and app
licable to more patients. No patients are presently scheduled for on-pump b
ypass surgery in our center. The purpose of this paper is to describe some
of the problems and pitfalls we have experienced and how to avoid them.