CORONARY-ARTERY SURGERY WITHOUT CARDIOPUL MONARY BYPASS - 5-YEAR EXPERIENCE

Introduction. Coronary surgery without extracorporeal circulation is n ow an accepted technique of myocardial revascularization. A progressiv e increase in operations has recently been observed. Objective. We rep ort our total experience with this technique in a consecutive series o f patients operated on since 1991. This series is compared with other series of patients who underwent coronary surgery using cardiopulmonar y bypass. Patients and methods. From December 1991 to July 1996, thirt y patients underwent myocardial revascularization without cardiopulmon ary bypass through median sternotomy at our institution. This group wa s retrospectively compared with 22 patients who received isolated coro nary artery bypass grafting with cardiopulmonary bypass (excluding reo perations) during the same period of time. Results. There were two hos pital deaths and one case of myocardial infarction during the early po stoperative period which required urgent reintervention. There were tw o variables showing a statistically significant difference between the groups with and without cardiopulmonary bypass. Incidence of nonfatal preoperative myocardial infarction increased (53% vs 23%), whereas mi nor mechanical ventilation time was reported (7 +/- 5 vs 14 +/- 9 h) i n the group without cardiopulmonary bypass. Follow-up (1 to 55 months after operation, mean 29 months) was completed. There were no cardiac- related deaths. No return of angina nor any new myocardial infarctions were recorded. New myocardial revascularizations were not necessary. Conclusions. Myocardial revascularization without extracorporeal circu lation obtained good results that were similar to conventional procedu res and were cost-effective.