Early postoperative complications after coronary artery bypass grafting at the Cardiovascular Center of Puerto Rico and the Caribbean

RESUMO

OBJECTIVES: This study describes the preoperative cardiovascular characteristics, intraoperative data, in-hospital complications and factors associated to procedural-related complications in patients undergoing coronary artery bypass grafting (CABG). BACKGROUND: There is a growing body of evidence of CABG safety and efficacy; however, limited data is available regarding the value of this surgical procedure in the Puerto Rican population. METHODS: We retrospectively reviewed the medical records of 200 consecutive patients submitted to CABG at the Cardiovascular Center of Puerto Rico and the Caribbean over a three-month period in 1997. Bivariate and multivariate analyses were performed to determine factors associated with the occurrence of complications. RESULTS: The most frequent cardiac risk factor was hypertension (77 per cent); stable angina (60.5 per cent) was the predominant cardiac clinical diagnosis. Three vessel disease with proximal left anterior descending coronary artery stenosis (42.1 per cent) was the most common anatomical lesion. The rate of major complications such as death (3 per cent), perioperative myocardial infarction (2 per cent), reoperation to control bleeding (1.5 per cent), pulmonary embolism (1 per cent), and stroke (1 per cent) was low and similar to the rate reported elsewhere. Multivariate analysis showed that non-use of LIMA graft, extended hospital stay, prolonged cardiopulmonary bypass time, and left ventricular dysfunction were significantly associated with the occurrence of complications (p < 0.05); on the other hand, there was a trend for older age to be associated with the occurrence of complications (p = 0.057). CONCLUSIONS: CABG is being performed with an acceptably low complication rate in this institution.