Canadian Journal of Anesthesia, Vol 30, 629-634, Copyright © 1983 by Canadian Anesthesiologists' Society

Clinical Reports: Non-Cardiac Surgery in Patients with Prior Myocardial Revascularization

¹ Department of Anesthesiology, Emory University Hospital, Atlanta, Georgia

Address correspondence to: Patricia M, Cruchley, MD, Dept. of Anaesthesia, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, MSB 1W8

Patients who had undergone aorto-coronary bypass grafts (ACBG) were assessed for the incidence of cardiac complications in the postoperative period following subsequent non-cardiac surgery. One hundred and twenty-one patients had 13 complications (11 percent). A significantly higher risk of cardiac complications (27 per cent) was found in patients undergoing non-cardiac procedures in the first month after ACBG. This remained higher (17 per cent) until the sixth month following ACBG. Significant factors which increased the risk of cardiac complications in the postoperative period included preoperative congestive heart failure (33 per cent), cardiac risk index score classification of III or IV (37 per cent), surgery on major vessels, and surgery necessitated because of a complication of the ACBG itself (17 per cent). No correlation was found between cardiac complication rates and recurrent angina, hypertension, the use. of beta-blockers or digoxin, or anaesthetic technique. It is suggested that all but emergency surgery should be postponed in the first month following ACBG, and elective surgery be delayed for up to six month

Key Words: ANAESTHESIA: cardiovascular • SURGERY: prior cardiac • COMPLICATIONS, POSTOPERATIVE: myocardial infarction, cardiac