[The postoperative myocardial infarct in the surgical therapy of pelvic and leg arterial occlusions].
A total of 4063 surgical interventions for arterial occlusions of the lower limbs have been reviewed in a retrospective study. As compared to patients without specific diagnosis of preexisting coronary heart disease, the incidence of postoperative myocardial infarction is 10 times greater in the presence of clinical and electrocardiographic evidence of previous infarction; for patients suffering from typical angina pectoris the risk is 5 times higher and for patients with suspected preoperative infarction the incidence of postoperative infarction is 3 times that in surgical patients without such a history. The mortality rate from myocardial infarction occurring postoperatively in patients with no previous history of coronary heart disease is 26% as compared to 100% for patients who had sustained preoperative infarction. The rate of recurrence is significantly greater when the time interval between previous myocardial infarction and operation is less than three months. Comparison between elective and emergency cases shows that in the group undergoing emergency surgery the incidence of post-operative infarction is twice that under elective surgery, whereas mortality from myocardial infarction is 3 times higher following acute interventions. The problem of critical establishment of surgical indication, the need for accurate prior investigations and the requirement of adequate preoperative treatment are discussed.
D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D010388:Pelvis; D011183:Postoperative Complications