Fifty-one consecutive adult patients with functional capacity of Class III -IV who have rheumatic valvular and congenital heart disease underwent open heart surgery at the Philippine Heart Center for Asia from October 1979 to February 1981. Because of religious convictions and beliefs, blood transfusion was witheld and definite criteria for operation were set. Technique of the procedure is hereby presented. Success of surgery was evaluated in terms of blood gas analysis, chest tubes drainage, hemoglobin level, hospital stay and OPD follow up. Results showed no significant differences in blood gas analysis, and all patients were doing fine at OPD follow up.