[Myocardial revascularization surgery without extracorporeal circulation. (Preliminary experience)]. / Cirugía de revascularización del miocardio sin la asistencia de circulación extracorpórea. (Experiencia preliminar).

Two hundred and three (203) open heart surgical procedures have been performed at the Complejo Hospitalario Metropolitano, from January 1997 to august 1998; Hundred and twenty-three (123) were of myocardial revascularization and twenty-four (24) of these patients were selected for revascularization without the assistance of the extracorporeal circulation machine. They were patients with chronic stable angina and had lesions of more than 95% in the descending anterior artery, high ventriculo-lateral branch and right coronary artery up to the crux cordis. In nineteen (19) patients the surgical approach was though a medical sternotomy; in four (4) through a left anterolateral thoracostomy and in three (3) of these patients a transverse sternotomy was added. There were no deaths perioperatively and at thirty (30) days there were no evidences of new Q waves or residual angina. With this technique, the time in the Intensive Care Unit and in the hospital has diminished; the patients also required less time in mechanical ventilation; less vasoactive amines are needed. In the operating room less equipment is necessary and the costs are significantly lower.

[New dosage of heparin during cardiac surgery with extracorporeal circulation]. / Nueva dosis de heparina durante cirugía cardíaca con circulación extracorpórea.

We studied the effect of 4 mg/kg of heparine, measured with the activity cosgulation time (hemocron), in cardiac surgical patients operated with extracorporeal circulation. The basal TCA was 118 +/- 13 seg with this doses of heparine. The majority of the patients (83.33%) with 4 mg/kg of heparine had more than 450 seg in comparison with the number of patients (30%) who had more than 450 seg with 3 mg/kg of heparine.