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The Annals of Thoracic Surgery, Vol 41, 42-50, Copyright © 1986 by The Society of Thoracic Surgeons
ED Foster, KB Davis, JA Carpenter, S Abele and D Fray
It has been suggested that coronary artery bypass grafting (CABG) is
efficacious in patients with severe coronary artery disease before they
undergo a major noncardiac operation. The Coronary Artery Surgery Study
(CASS) registry population was reviewed to identify variables affecting
operative mortality and cardiovascular morbidity for noncardiac procedures,
and to assess the influence of prior CABG on these surgical risks. Major
noncardiac operations were performed on 1,600 registry patients between
June 30, 1978, and June 30, 1981. Operative mortality for individuals
without significant coronary artery disease (Group 1) was 0.5% (2/399) and
for patients with such disease having CABG prior to a noncardiac procedure
(Group 2), it was 0.9% (7/743) (Group 1 versus Group 2, p = 0.42). Patients
with significant coronary artery disease undergoing noncardiac operation
without prior CABG (Group 3) had an increased operative mortality, 2.4%
(11/458) (p = 0.009). Group 2 patients had more severe angina symptoms (p
less than 0.001) and more extensive coronary artery disease (p less than
0.001) on entering CASS than Group 3 patients. Postoperative chest pain
occurred in 8.7% (40/458) of the Group 3 patients versus 4.5% (18/399) in
Group 1 and 5.1% (38/743) in Group 2 (p = 0.004). No group differences were
noted for the incidence of perioperative myocardial infarction or
arrhythmias.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Risk of noncardiac operation in patients with defined coronary disease: The Coronary Artery Surgery Study (CASS) registry experience
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