CORONARY-ARTERY BYPASS-GRAFTING IN PATIENTS WITH CHRONIC LYMPHOCYTIC-LEUKEMIA

Chronic lymphocytic leukemia is a disease of the elderly. It tends to have a variable clinical course. Because of the patients' immunologica lly dysfunctional state, there has been reluctance to perform open car diac procedures because of concern about early postoperative sepsis le ading to death. To assess the risk of coronary artery bypass grafting in elderly patients, the records of 26 patients (mean age, 69.6 +/- 4. 9 years) with chronic lymphocytic leukemia who underwent coronary arte ry bypass grafting between january 1975 and July 1990 were retrospecti vely reviewed. Nineteen underwent isolated coronary artery bypass graf ting, and 7 had combined procedures. The operative mortality rate was 7.7%. Postoperative infections developed in 6 patients (23.1%): pneumo nia in 3 and sternal osteomyelitis, acute parotiditis, and bacteremia in 1 each. One of these 6 patients died of acute Serratia pneumonitis. Twenty-four patients (92.3%) were discharged from the hospital an ave rage of 10.6 +/- 7.7 days postoperatively. Patients with chronic lymph ocytic leukemia can undergo coronary artery bypass grafting with accep table mortality but with increased risk of postoperative infection.