The authors describe their experience with 22 patients who underwent the fast-tract anaesthesia with alfentanil for the lesion of aortic valve, ascending aorta or mitral valve. 8 patients had moderate risk for the surgery (EuroSCORE 3–5) and 11 patients had high risk for the surgery (EuroSCORE>6). 8 patients (36.3%) were extubated 10 minutes after the end of the procedure in the operating room. The average time of mechanical ventilation in other patients was 51±45 minutes. No patient was reintubated for the respiratory or cardiac failure. Average length of stay in the intensive care unit was 2.2±1.4 days. No patient died in 30 postoperative days. The authors’opinion is that the fast-track anaesthesia with alfentanil and without thoracic epidural analgesia is also suitable for cardiac surgery requiring cardiopulmonary bypass in high risk patients.

        Key words: fast-track anaesthesia – alfentanil – heart valves surgery