Related Experiment Videos
Concomitant coronary artery bypass and major noncardiac surgery
Insights
Performing noncardiac surgery with coronary artery bypass grafting (CABG) is safe and effective. This study found a low operative mortality rate for combined procedures, suggesting it
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Concomitant cardiac and noncardiac procedures are increasingly common.
- Coronary artery bypass grafting (CABG) is frequently performed.
- Simultaneous noncardiac procedures with CABG are less common.
Purpose of the Study:
- To evaluate the safety and efficacy of performing noncardiac procedures concurrently with CABG.
- To assess the operative mortality of combined procedures.
- To advocate for combined surgical approaches when indicated.
Main Methods:
- Retrospective review of 71 noncardiac procedures performed with CABG between 1971 and present.
- Analysis of patient demographics, concomitant procedures, and outcomes.
- Comparison of mortality rates with isolated CABG.
Main Results:
- The operative mortality rate for combined procedures was 2.9%.
- This rate compares favorably to the 1.7% mortality for isolated CABG.
- Common concomitant procedures included carotid endarterectomy (25 patients) and abdominal aortic aneurysm resection (3 patients).
Conclusions:
- Concomitant noncardiac surgery with CABG is associated with acceptable operative mortality.
- Combined procedures can be safely performed in selected patients.
- Consideration of combined surgery is warranted for patients with coronary heart disease and coexisting noncardiac conditions.
Abstract:
Concomitant cardiac procedures performed in conjunction with coronary bypass have become commonplace, but not concomitant noncardiac procedures. Bernhard and associates were the first to report concomitant coronary bypass and carotid endarterectomy. This series, begun in 1971, consists of 71 noncardiac procedures performed concomitantly with coronary bypass on 68 patients. Thirty-seven procedures were performed for associated vascular disease, including carotid endarterectomy (25 patients) and resection of abdominal aortic aneurysm (three patients). Other concomitant problems included are thymoma, bronchogenic carcinoma, and hiatal hernia. The operative mortality rate of 2.9 percent compares very favorably with that of 1.7 percent in our group of patients having isolated coronary artery bypass. A plea is made for consideration of concomitant surgery in patients with operable coronary heart disease who have an additional serious noncardiac surgical disease.