The incidence and management of "medical" complications following cardiac operations.

THE DIRECT MORTALITY associated with operations upon the heart and great vessels has steadily declined as surgeons have become more familiar with the operative management of various congenital and acquired malformations, and as improvements have been made in methods of preoperative preparation, the conduct of cardiopulmonary bypass, and in postoperative management. Nevertheless, complications secondary to the operation, usually occurring in the early postoperative period, may still represent serious threats to the patient's survival. These complications involve disturbances in the cardiac rhythm and contractile state, electrolyte balance, as well as in the functions of the renal, pulmonary, gastrointestinal, hematopoietic, or central nervous systems. Because of the nature of these complications, they are managed most effectively by the combined efforts of internist or cardiologist and the cardiovascular surgeon, and are frequently termed the "<medical" complications of cardiac operations. Some of these complications are seen only in postoperative patients; although others may also occur in patients who have not been operated upon, their manifestations and methods of management may be quite different