This study evaluates the efficacy of using a hemoadsorption cartridge to remove antithrombotic drugs during off-pump coronary artery bypass grafting (OPCAB). Ten patients, predominantly male and with a mean age of 67.4 years, were treated with antithrombotics like ticagrelor and rivaroxaban. Hemoadsorption was integrated into the perioperative management using either a dialysis device or a standalone apheresis pump, showing a mean treatment time of 145 minutes. Results indicated low rates of bleeding, no deaths, or further interventions during a mean follow-up of 19.5 months, demonstrating that this method is feasible and safe.