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According to a new study by iData Research, approximately 340,000 CABG procedures per year are performed in the United States. A CABG (Coronary Artery Bypass Grafting) procedure is a common cardiac surgery where a harvested vein is grafted onto the heart to bypass blocked arteries.
This procedure can be done on-pump (ONCAB), where a cardioplegic solution is used to stop the heart and the patient’s circulatory system is temporarily maintained through the use of a cardiopulmonary bypass (CPB), or off-pump (OPCAB), also known as beating heart surgery.
The use of a CPB pump for circulation exposes the patient’s blood to foreign surfaces, which has been shown to increase the incidence of bleeding and short-term neurocognitive defects, known as postperfusion syndrome (PPS) or “pump head.” Symptoms of PPS are subtle and include defects associated with attention, concentration, short-term memory, and fine motor function. Additionally, stopping the heart may result in impairment to the heart muscle. Clamping of the aorta has been shown, in certain studies, to release thrombogenic agents that may result in strokes. These negative drawbacks to performing ONCAB procedures have encouraged more surgeons to switch to off-pump and minimally invasive techniques when performing CABG procedures.
However, many physicians still prefer the ONCAB method. Procedural analysis by iData Research found that, in 2017, approximately 17.6% of total CABG procedures were performed using OPCAB, while the remainder and majority of surgeons chose the ONCAB method. “Surgeons are reluctant to switch to the OPCAB methods, which require additional training as operating on a beating heart demands the application of more tedious, difficult techniques,” explains Sean Collins, Analyst Manager at iData Research. Many cardiac surgeons, particularly of the older generation, prefer ONCAB techniques and are less likely to adopt OPCAB methods. This reluctance to adopt OPCAB will impede further growth of this market.
The U.S. market for disposable ONCAB devices is directly related to the number of ONCAB procedures, and likewise for OPCAB devices and OPCAB procedures. Advancements in PCI technology, an alternate method for coronary vascularization, are expected to contribute to a decline in total CABG procedures; PCI procedures absolve patients from the risk of PPS associated with ONCAB, and surgeons, from the inherent procedural difficulties with performing OPCAB. Although the decrease in CABG procedures will be mitigated by the aging U.S. population, the net change in the number of annual CABG procedures is still forecasted to be negative. The close relationship between procedure volumes and unit sales of CABG-related devices will trigger a decrease in the value of the U.S. market for both ONCAB and OPCAB devices.
For More Information
More research on the coronary artery bypass grafting device markets can be found in the full report suite titled U.S. Market Report Suite for Cardiac Surgery and Heart Valve Devices, which provides a comprehensive report on units sold, market values, average selling prices, procedure volumes, forecasts, as well as detailed competitive market shares and analysis of all major competitors.
This suite of reports include segments for tissue heart valves, mechanical heart valves, annuloplasty repair devices, transcatheter mitral valve repair devices, transcatheter aortic valve replacement devices, devices used to perform on and off-pump coronary artery bypass procedures, endoscopic vessel harvesting devices, anastomosis assist devices, transmyocardial revascularization devices, ventricular assist devices, intra-aortic balloon pumps, artificial heart devices, remote hemodynamic monitoring devices, patent foramen ovale closure devices, atrial septal defect closure devices, ventricular septal defect closure devices and left atrial appendage closure devices.