The authors analyse the results of 391 consecutive non-selected patients who underwent direct myocardial revascularization (MR) without cardiopulmonary bypass (CPB) from September 1981 to February 1985. In the same period we performed a total of 1568 revascularization procedures; thus 24.9% were MR without CPB. Out of the 391 patients, 318 (81.3%) were male and the ages varied from 35 to 76, with a median of 56 y/o. The surgical procedure was performed due to: chronic coronary insufficiency 286 (73.1%), after coronary thrombolysis 42 (10.7%), evolving acute myocardial infarction 18 (4.6%), ill-succeeded angioplasty 18 (4.6%), redos 14 (3.6%), intermediate syndrome 12 (3.1 %) and chronic aortic dissection 1. Single bypass was performed in 175 (44.7%) patients, double in 192 (49.1%) and triple in 24 (6.1%) with an average of 1.6 grafts/patient. The mammary artery was utilized 10Q times, bovine heterologous mammary 2 and all remaining cases received saphenous vein grafts. The hospital mortality was 2.5% (10/391) which is significantly different from our 5% hospital mortality in 1177 patients operated on the same period with CPB. We prospectively compared the postoperative complications in 378 patients without CPB against 689 patients with CPB concerning arrhythmias, perioperative myocardial infarction, neurologic, infectious, pulmonary and hemorrhagic complications.
myocardial revascularization, direct; extracorporeal circulation