Venous Thromboembolic Complications After Open Heart Surgery

Abstract

The incidence and impact of venous thromboembolic complications on pa tient survival following cardiac operations remains unclear. During a five-year period (1984-1988) 4,393 patients underwent open heart surgery; of these, 13 patients had either pulmonary embolus (PE) (5 patients) or deep-vein thrombo sis (DVT) (8 patients). In the PE group, coronary artery bypass grafting was performed in 3 patients, aortic valve replacement in 2. Seven patients had myocardial revascularization and 1 had aortic valve replacement in the DVT group. Postoperative diagnosis was established by means of lung scan (4) or pulmonary angiogram (1) for PE or venous Doppler (4) or contrast venography (4) for DVT. Treatment was supportive with anticoagulation in all patients; 2 underwent interruption of the vena cava. Hospital stay was prolonged in all with an average of thirty-four days. PE accounted for the death of 1 patient. Actuarial survival at five years among the survivors was 92%. This experience suggests that the occurrence of venous thromboembolic events after open heart surgery is rare (overall incidence of 0.3%); however, an awareness of this poten tially lethal complication is still necessary.