Methods

Bleeding and the complications related to hemotransfusion continue to be 1 of the major factors of morbidity and mortality in cardiac surgery. Knowledge about the risk factors 1 for this com-plication is fundamental for the adoption of therapeutic and pre-ventive measures. However, the multifactorial nature of the problem requires the implementation of universal protocols 2, invariably implying alterations in coagulation caused by extracorporeal circulation. The methods proposed to minimize blood loss in cardiac surgery include the use of cell saver 3, autotransfusion4, heparin-bonded circuits 5, leukocyte filters 6, and antifibrinolytic drugs 7. The di-sadvantages of these methods reside in their elevated costs for routine, wide implementation. The advent of myocardial revascularization without extracor-poreal circulation has renewed interest in this field due to incor-poration of new technology and knowledge of its results, confirming its feasibility in a large group of patients 8. Recent studies 9,10 have suggested that this technique reduces postoperative bleeding, the need for transfusion, and hospital costs. Few studies specifically analyze smaller blood loss as an advantage of myocardial revascu-larization without extracorporeal circulation, with relevant impli-cations in terms of postoperative morbidity. This study aimed at comparing myocardial revascularization with and without extracorporeal circulation in regard to postope-rative bleeding and the need for blood and hemoderivate transfusion