Abstract
Two hundred diabetic coronary artery heart disease patients were operated during a fifty-four-month period. The total number of coronary artery bypass grafting (CABG) operations performed in this period was 1300. Emergency CABG operations were excluded from this study. The diabetic patient population was subclassified as having latent diabetes, diabetes regulated with diet or oral antidiabetic agents, and insulin-dependent diabetes mellitus (IDDM). Congestive heart failure and left ventricular hypertrophy seen in the diabetic population was a significant clinical feature as compared with the nondiabetic patients. An giographically the distribution of localized coronary artery lesions was similar, but a diffuse atherosclerotic vessel disease pattern was prominent in the diabetic group. Segmental wall motion in diabetic patients revealed severe ventricular dysfunction as compared with the nondiabetic group. Hospital mortality was 6.8% to 8.5 % in favor of the nondiabetic group. Low cardiac output, renal complications, mediastinitis, and wound infections were encountered more fre quently in the diabetic patients. The distal coronary artery anastomosis rates in nondiabetic and diabetic patients were 2.8 and 3.1 respectively.
The high rate of vascular and metabolic complications seen in this systemic disease has led the authors to accept diabetes mellitus as a risk factor in CABG surgery.
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