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Ann Thorac Surg 1976;21:528-531
© 1976 The Society of Thoracic Surgeons

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Articles

Unexpected Death Following Aortocoronary Bypass

Cardiac Surgical Service, St. Thomas Hospital, and the Department of Thoracic Surgery, Vanderbilt University Medical School, Nashville, TN

^* Address reprint requests to Dr. Stoney, St. Thomas Medical Building, Suite 501, 4230 Harding Rd, Nashville, TN 37205

Since 1968, 1,800 aortocoronary bypass procedures have been performed with 37 operative or early postoperative deaths (2.1%). Twenty-one deaths (57%) occurred in patients with one or more of the following predetermined risk factors: ventricular aneurysm, decreased left ventricular contractility, left main coronary artery stenosis, valve replacement, recent infarction, or cardiogenic shock. The remaining 16 deaths (43%) were unexpected and occurred in patients with none of these risk factors.

The most prominent single technical problem in both groups was related to the ascending aorta. Acute aortic dissection or rupture of the vein-aortic anastomosis resulted in 6 deaths.

Although the majority of the patients ultimately died of cardiac or respiratory failure or a combination of the two, a specific preceding catastrophe could be identified in 22 (59%) patients.

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