It Is Not a Shame to Take Precautions

We read with great interest the article by Guven and Cetintas.[1] We would like to congratulate the authors for providing valuable evidence on the topic.

We have followed this on-pump beating-heart approach for over two decades. So, we feel compelled to share our support for the findings. Although we have not yet formally collected our data, our consistent clinical experience confirms what the authors describe: this technique is not at all a “minor” method; it is, in fact, a pragmatic and versatile solution, especially in complex or evolving intraoperative conditions.

Importantly, we have found the method to be extremely helpful during a surgeon's learning curve and when adapting to a new anesthesiologic team. It offers a reassuring safety net without substantially altering surgical planning or incurring significant additional costs.

Furthermore, we believe its utility is not confined to unstable or high-risk patients. Even in stable cases, it can facilitate surgical flow and decision-making, particularly in technically demanding revascularizations. The ability to maintain hemodynamic control while achieving complete revascularization should not be underestimated.

Once again, we thank the authors for their contribution. Their work gives voice and validation to a surgical strategy that many teams have quietly relied upon for years. Indeed, it is not a shame to take precautions; it is a sign of professionalism.

Publication History

Received: 09 July 2025

Accepted: 28 July 2025

Article published online:
14 August 2025

• References

• 1 Guven H, Cetintas D. Cardiopulmonary Bypass-Supported Coronary Artery Bypass Surgery: A Flexible and Effective Alternative to Off-Pump Surgery. Thorac Cardiovasc Surg 2025; (e-pub ahead of print).