Results of coronary artery surgery in patients receiving propranolol

Abstract

Beta adrenergic blockade at the time of direct coronary revascularization has theoretical disadvantages and is considered by some to be dangerously depressing to the myocardium in the immediate period after pump oxygenation. A review of 100 consecutive cases of bypass surgery revealed that 25 patients had been taking propranolol to within 24 hours or less before surgery in dosages ranging from 40 to 200 mg. per day. The over-all operative mortality rate was 2 per cent. Neither of the patients who died had been receiving propranolol. Seven of the patients taking the drug required emergency surgery for the preinfarction state. In this group the doses were largest and most proximate to surgery. Nevertheless, none of these patients died. The magnitude of surgery was similar in elective and emergency settings and in those with and without propranolol therapy. We have concluded that coronary revascularization is safe in patients receiving propranolol so long as complete revascularization is done.