title: Morbidity and mortality associated with dental extraction before cardiac operation.
abstract: BACKGROUND
  Dental extraction of abscessed or infected teeth before cardiac operation is often performed to decrease perioperative infection and late endocarditis. Literature to support dental extraction before cardiac operation is limited. The goal of this study was to evaluate the risk of major adverse outcomes in patients undergoing dental extraction before cardiovascular surgical procedures.
  
  
  METHODS
  A retrospective review was performed to identify patients who underwent dental extraction before planned cardiac operation. Major adverse outcomes within 30 days after dental extraction or until time of cardiac operation were recorded and defined as death, acute coronary syndrome, stroke, renal failure requiring dialysis, and need for postoperative mechanical ventilation.
  
  
  RESULTS
  Two hundred five patients underwent 208 dental extractions before 206 planned cardiac operations. Major adverse outcomes occurred in 16 of 205 patients (8%). Twelve patients (6%) died within 30 days after dental extraction, of which 6 (3%) occurred before cardiac operation, and 6 (3%) occurred after cardiac operation.
  
  
  CONCLUSIONS
  Patients with planned dental extraction before cardiac operation are at risk for major adverse outcomes, including a 3% risk of death before cardiac operation and an 8% risk of a major adverse outcome. The prevalence of major adverse outcomes should advise physicians to evaluate individualized risk of anesthesia and surgical procedures in this patient population.
authors.affiliation: Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Smith
authors.affiliation: Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: David W
authors.initials: DW
authors.lastname: Barbara
authors.affiliation: Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: William J
authors.initials: WJ
authors.lastname: Mauermann
authors.affiliation: Department of Oral and Maxillofacial Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Viozzi
authors.affiliation: Department of Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Dearani
authors.affiliation: Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota. Electronic address: grim.kendra@mayo.edu.
authors.forename: Kendra J
authors.initials: KJ
authors.lastname: Grim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D014081:Tooth Extraction / Q000009:adverse effects* / Q000401:mortality*; D055815:Young Adult