The safety of combined cardiac and vascular operations: how much is too much?

Objective: The purpose of this study was to identify factors correlating wi th a poor outcome following combined cardiac and vascular procedures. Methods: We reviewed 45 consecutive patients undergoing combined cardiac an d vascular operations. These included cardiac/CEA (n = 27), cardiac/AAA (n = 13), cardiac/AAA/one other vascular reconstruction (n = 4), and cardiac/r enal artery bypass (n = 1). Group I included all patients with no morbidity or mortality (n = 41) and Group II included patients who died or suffered significant morbidity (stroke, renal failure) (n = 4), Results: Overall mortality was 4.4% (2/45). These two patients underwent ca rdiac surgery combined with two additional vascular procedures (cardiac/AAA /other), In patients undergoing cardiac/CEA or cardiac/AAA, there were no d eaths and one stroke (contralateral to CEA). Group II had significantly dec reased ejection fraction (39% +/- 6% vs 52% +/- 1%) and an increased number of procedures (2.75 vs 2.04). Conclusions: Combined cardiac surgery and Vascular reconstruction can be pe rformed safely. However, multiple Vascular reconstructions or the presence of decreased ejection fraction increased operative risk (C) 2000 Published by Elsevier Science Ltd on behalf of The International Society for Cardiova scular Surgery.