In summary, even when off-pump surgery is performed by experienced off-pump surgeons averaging around 500 prior off-pump cases and performing >80% of their cases off-pump, rates of incomplete revascularization and late mortality are significantly worse with off-pump surgery compared with on-pump coronary bypass. These data support the conclusion that, for most patients without contraindications to cardiopulmonary bypass undergoing surgical revascularization, on-pump coronary bypass remains the appropriate choice.