The Cerebrovascular Accident and Coronary Occlusion in Anesthesia

A study was made to estimate the anesthetic risk in a patient with a previous coronary occlusion or cerebrovascular accident and to answer the question, "How long should one wait following an occlusion before elective surgery could be performed with reasonable safety?" A group of 8,984 male surgical patients over 50 years of age were evaluated for preoperative coronary occlusions and cerebrovascular accidents, and for postoperative recurrences. Of the 427 patients with preoperative coronary occlusions, 26 suffered a postoperative occlusion, with a mortality of 15. Of the 8,557 patients with no preoperative occlusion, 59 suffered postoperative complications and 11 died. The incidence of recurrence of a coronary occlusion following surgery is definitely diminished if the occlusion has occurred 2 years or more before surgery, and is no higher than in the population with no preoperative coronary occlusion.