Twenty-six nonrandomized patients undergoing emergent coronary artery bypass operation were assigned to either the cold group (traditional intermittent cold blood cardioplegia and slight hypothermic cardiopulmonary bypass (n = 7) or the warm group (intermittent warm blood cardioplegia and normothermic cardiopulmonary bypass) (n = 19). Preoperative variables were similar in both groups except the number of renal dysfunction patients were greater in the cold group. The time from removal of the aortic crossclamp to discontinuation of cardiopulmonary bypass was significantly shorter in the warm group and the incidence of heartbeat spontaniously converted to normal sinus rhythm after removal of the aortic crossclamp was higher in the warm group. The warm group showed good results concerning postoperative blood loss volume, change of base excess, time required for awakening and extubation. Significant differences were found in the hospital mortality rates between the groups (cold: 57.1%, warm: 5.3%). This study suggested a beneficial influence of warm heart surgery on postoperative hemodynamics, metabolic recovery and hospital mortality in emergent coronary artery bypass grafting.