The aim of coronary artery bypass grafting (CABG) is to prolong life and reduce symptoms. However, when compared with percutaneous coronary intervention, CABG is a significantly more invasive operation, associated with a higher rate of early stroke. Off-pump CAB (OPCAB) brought the hope, about 25 years ago, that various CABG-related morbidities, and even perhaps mortality, would evaporate if cardiopulmonary bypass was to be eliminated. Yet, numerous risk-adjusted studies and large meta-analysis of propensity score-adjusted studies showed that this hoped superiority of OPCAB regarding mortality and several short-term outcomes did not materialize in large randomized trials