Total myocardial revascularization without cardiopulmonary bypass: a reality

From January 1995 to June 1999 our surgical team at ICORP, Fortaleza, Ceará, Brazil, performed coronary artery surgery without cardiopulmonary bypass as a routine procedure. A total of 897 operations were performed during this period, 91.8 % (824) of them without cardiopulmonary bypass. The purpose of the present study is to evaluate the results of these 824 patients with regard to duration of hospitalization, age, sex, number of grafts, reoperations performed, morbidity and mortality. All patients underwent previous coronary arteriography.

With patients admitted in the hospital for elective or emergency myocardial revascularization, all the coronary arteries were bypassed, possibly without cardiopulmonary bypass, including the marginal branches of the circumflex artery. Basic statistical analysis has been performed over the above-mentioned variables.

The patients' ages ranged from 35 to 88 years, with a mean age of 61.2. The average duration of hospitalization was seven days. In all, 1,738 grafts were implanted, the number in individual patients varying from one to four (average of 2.1 per patient). The incidence of procedure-related complications was 3.15% (26 patients). Twenty-three patients (2.8%) died in the early postoperative period.

Considering the data obtained from this study, we conclude that the procedure can be used in the vast majority of patients undergoing coronary artery surgery (compared to the similar studies of patients operated on with cardiopulmonary bypass).