The Journal of Thoracic and Cardiovascular Surgery, Vol 75, 621-624, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Concomitant coronary artery bypass and major noncardiac surgery
ML Dalton Jr, TM Parker, JJ Mistrot and DL Bricker
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.