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

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%); stable angina (60.5%) was the predominant cardiac clinical diagnosis. Three vessel disease with proximal left anterior descending coronary artery stenosis (42.1%) was the most common anatomical lesion. The rate of major complications such as death (3%), perioperative myocardial infarction (2%), reoperation to control bleeding (1.5%), pulmonary embolism (1%), and stroke (1%) 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.