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European Journal of Cardio-Thoracic Surgery, Vol 4, 504-507, Copyright © 1990 by European Association for Cardio-thoracic Surgery
E Buffolo, JC Andrade, JN Branco, LF Aguiar, EE Ribeiro and AD Jatene
The authors present the results of 593 consecutive and non-selected
patients who underwent direct myocardial revascularization without
extracorporeal circulation in the period September 1981 to December 1988.
The results are compared with 3086 patients who underwent conventional
bypass surgery over the same period of time. The ages varied from 33 to 80
years (mean = 56) with 40 patients older than 70. The overall mortality in
the group without cardiopulmonary bypass (CPB) was 1.7% (10/593) compared
with 3.8% for conventional revascularization. Our mortality in the last 3
years has been 0.5% and 0% in the last 203 patients revascularized without
CPB. The number of grafts varied from 1 to 5 (average 1.6). The treated
arteries were: anterior descending (557), right (282) marginal (5) and
circumflex marginal (4). Immediate postoperative complications were fewer
and hospital discharge was earlier in the group treated without CPB. The
authors conclude that this tactical alternative has the advantages of:
lower morbidity and mortality, lower cost and no need for blood
transfusion. Drawbacks are the need for greater technical expertise and it
seems to be possible in about 19% of all patients who undergo myocardial
revascularization.
ARTICLES
Myocardial revascularization without extracorporeal circulation. Seven- year experience in 593 cases
Cardiothoracic Division, Hospital Sao Paulo, University Hospital, Brazil.
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