Timing of high-risk vascular surgery following coronary artery bypass surgery: a 10-year experience from an academic medical centre.

Abstract

Major non-cardiac surgery within 40 days of coronary angioplasty with stenting has high cardiac complication rates. We have performed a case-control study to determine whether the risk of vascular surgery might have increased in recent survivors of coronary artery bypass surgery (CABG). Using our vascular database from 1990 to 1999, we matched the cases who had vascular surgery within a month of CABG with controls by pre-operative comorbidities of diabetes mellitus, history of myocardial infarction (MI), history of congestive heart failure (CHF), and chronic renal insufficiency and compared the incidence of peri-operative MI, CHF, death, and other complications. Compared to case-matched controls, patients who underwent vascular surgery within a month of CABG suffered significantly greater mortality (20.6% vs. 3.9%, p < 0.005). The incidence of non-fatal cardiac complications was not significantly different between the groups. We conclude that the risk of mortality may be significantly greater in patients undergoing major vascular surgery within a month of CABG.