Off-pump CABG and Zamvar pericardial fold

  • Om Prakash YadavaEmail author
  • Vipin Zamvar
Video Article


This is a free conversation with the originator of the 'Zamvar pericardial fold' on the status of Off Pump Coronary Artery Bypass Surgery. An attached video describes the technique of taking the Lima stitch through the Zamvar's pericardial fold.


Off-pump CABG Zamvar pericardial fold Lima sitich 

Dr. Zamvar feels that both pump and off-pump techniques of coronary artery bypass surgery (CABG) are equally good for routine surgeries. However, for high-risk cases, off-pump scores over on-pump surgery. He describes the Zamvar pericardial fold for taking the deep pericardial stitch (Lima stitch—Video 1). This fold runs from the superior aspect of left superior pulmonary vein to the lower end of the left inferior pulmonary vein and is formed due to the visceral pericardium taking a double U-turn over the left-sided pulmonary veins before becoming the parietal pericardium [1]. Dr. Zamvar feels that it is not necessary for trainees to do on-pump surgery before doing off-pump CABG. However, it does help to visit various mentors, after a certain degree of proficiency has been achieved to learn the intricate nuances of the procedure.

Supplementary material

12055_2018_745_MOESM1_ESM.mp4 (134.3 mb)
Video 1 The taking of the Lima stitch through the Zamvar pericardial fold (MP4 137,505 kb)


  1. 1.
    Zamvar V. The Zamvar pericardial fold. J Cardiothorac Surg. 2017;12:84.CrossRefPubMedGoogle Scholar

Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2018

Authors and Affiliations

  1. 1.National Heart InstituteNew DelhiIndia
  2. 2.EdinburgUK

Personalised recommendations