Long-term cardiac prognosis following noncardiac surgery

Article Abstract:

In a study of 444 patients undergoing general surgery, those with chronic cardiovascular disease, previous congestive heart disease or coronary artery disease had the highest risk of severe cardiac problems up to two years after surgery. If a patient left surgery without having myocardial ischemia, they were unlikely to have serious in-hospital cardiac problems. Myocardial ischemia occurs when the blood supply to the heart is reduced. In-hospital postoperative ischemia occurred in 70% of the patients who developed cardiac problems. Of patients leaving the hospital in stable condition, 11% developed serious cardiac problems, most frequently one year after surgery. Patients with postoperative heart attacks or unstable angina had 20 times the rate of cardiac problems in the two years following surgery. These patients need aggressive, long-term follow-up and treatment.

Coronary heart disease

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In-hospital and long-term mortality in male veterans following noncardiac surgery

Article Abstract:

Patients with high blood pressure or kidney disease or who have led sedentary life styles have a higher risk of death following surgery. Of 474 patients undergoing general surgery, 26 died shortly after the operation, 59 died within the first year and 23 died within the second year after surgery. Chronic disease was the main indicator of long term survival. Kidney disease, congestive heart failure, obstructive pulmonary disease and surgery for cancer increased the mortality rate two to three times. After two years, 44% of patients with two of these diseases were no longer alive. Physicians should weigh the benefits and risk factors of recommending elective noncardiac surgery to patients with two or more of these risk factors. More than 75% of in-hospital deaths after surgery occurred several days to several weeks after surgery.

Hypertension, Kidney diseases

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Ventricular arrhythmias in patients undergoing noncardiac surgery

Article Abstract:

Patients with coronary artery disease (CAD) or who are at high risk for CAD do not need extensive monitoring for arrhythmias which may occur during surgery for other than heart disease. Of 230 men with CAD or its risk factors undergoing surgery, 101 (44%) had an arrhythmia before, during or after surgery. Patients who smoked, had a history of congestive heart failure or had an arrhythmia before surgery were most likely to have postoperative arrhythmias. Only one percent of patients who had arrhythmias before surgery developed more severe symptoms during surgery and only 10% developed them postoperatively. None of these patients had life-threatening arrhythmias.

Analysis, Ventricular fibrillation

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