Please help! what is the difference (including advantage and disadvantage) of off-pump and on-pump coronary artery bypass?

Very complicated.: Even after a lot fo studies, it is controversial. It depends on a lot of things. Some people have aortas that cannot be clamped or manipulated due to calcium. Off-pump bypass may be their only option. Other patients can't have off pump bypass. For most people, the decision should involve the patient, the surgeon, and other trusted physicians.