Cardiovascular performance and myocardial infarction following aortic surgery

A review of all patients who had undergone aortic reconstruction for aortoiliac occlusive disease and aneurysm over the previous five years demonstrated that fatal myocardial infarctions occurred most frequently two or three days remote from surgery. The most outstanding hemodynamic finding was sustained tachycardia which displayed a maximum risk on the second postoperative day. The peak coincided with the period of maximum incidence of fatal myocardial infarction. We suggest that the degree of postoperative tachycardia, which is a major determinant of myocardial oxygen consumption, contributes significantly to the risk of acute myocardial ischemia.