Use of the PercuSurge GuardWire distal balloon occlusion system as an endovascular clamp during off-pump coronary bypass surgery with the LIMA to the LAD.

Off-pump coronary bypass surgery is an alternative to conventional bypass surgery and has the potential to reduce perioperative morbidity. Current techniques of snaring or inserting a shunt into the coronary artery to occlude flow and allow for anastomotic construction carry the risk of vessel trauma and subsequent graft failure. We present two cases in which PercuSurge GuardWires were used as an endovascular clamp in a hybrid operating room/catheterization laboratory to transiently occlude flow down the native left anterior descending artery during left internal mammary artery anastamotic construction.