Direct coronary surgery with saphenous vein bypass without either cardiopulmonary bypass or cardiac arrest.

From October, 1980 to April, 1983, 30 patients underwent direct coronary surgery without either cardiopulmonary bypass or cardiac arrest. Patients were selected according to the site of the lesion or the condition of the vessel, i.e. generally arteries with a good calibre (more than 1.5 mm), without big plaques in the anastomotic area and lesions limited to the left anterior descending, the diagonal or the right coronary arteries, independently from the clinical condition or state of left ventricular function. Eighteen had stable angina, 10 unstable angina, 2 post-myocardial infarction angina, and 4 had a severe concomitant disease. The operations performed were: 17 simple aorto-coronary bypasses, 11 double bypasses and 2 triple bypasses. When it was necessary to revascularize the diagonal or the left anterior descending artery, the operating table was rotated to the right, a gauze pack was applied posteriorly and the arteries were sutured with 6-0 or 7-0 prolene sutures. There were no deaths and no perioperative infarctions. It should be noted that to date this technique could be used only on 7% of our patients, but we consider this percentage could be increased in the future.