Coronary revascularization without extracorporeal circulation. An alternative therapy (preliminary report)]

Direct myocardial revascularization techniques has earned great acceptance in the treatment of ischemic coronary syndromes in the past two decades. Almost since its beginnings the procedure was done with the aid of extracorporeal circulation, since the technical accessibility with cardiac standstill further helped to evolve the procedure. As years went by, complications due to the use of the pump became evident, such as microembolism, bleeding disorders, and others. Besides this, there is a special group of patients, those with high surgical risk, with preexisting pulmonary, hepatic or cerebral disease, who benefit a great deal when bypass grafting procedure is done without the pump. In this article we delineate the indications, contraindications, and the procedure itself based in our personal experience, reporting our first five patients with this technique.