What is the incidence of postoperative myocardial reinfarction in patients with a previous myocardial infarction undergoing general anesthesia, and how does the timing of surgery affect this risk?
The risk of postoperative myocardial reinfarction is exceptionally high (37%) when surgery under general anesthesia is performed within three months of a previous myocardial infarction.
During 1967 and 1968, a total of 32,877 patients had general anesthesia at the Mayo Clinic; 422 had previous myocardial infarction. Of these 6.6% experienced another infarction during the first postoperative week. There was no relationship between incidence of postoperative reinfarction and type or duration of anesthesia. However, operations on the thorax and upper abdomen were followed by three times as many reinfarctions as operations at other sites. Patients who were operated on within three months of infarction had a 37% reinfarction rate. This rate decreased to 16% in patients at three to six months after infarction, and remained at 4% to 5% when infarction had occurred more than six months previously. A significantly higher number of myocardial infarctions occurred during the third postoperative day.
Sait Tarhan (Mon,) studied this question.
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