Improved operative risk after myocardial revascularization.

: At Ochsner Medical Institutions from 1970 to 1979, 96 patients who had previously had myocardial revascularization later had a total of 136 noncardiac operations. There were no postoperative myocardial infarctions and only one noncardiac death. Transitory postoperative arrhythmias occurred in 3.6% of patients. It appears that myocardial revascularization protects the cardiac patient from myocardial infarction and cardiac-related deaths during and after noncardiac operations. Patients with cardiac disease scheduled for elective surgery should have exercise testing or coronary cineangiography or both to evaluate the severity and significance of the coronary disease. If significant coronary lesions are demonstrated that are amenable to a bypass procedure, the operative risk will be lessened by prior revascularization.