Perioperative cardiac complications in patients undergoing head and neck free flap reconstruction

Publication date: Available online 6 April 2017
Source:American Journal of Otolaryngology
Author(s): Peter J. Ciolek, Kate Clancy, Michael A. Fritz, Eric D. Lamarre
BackgroundLimited data exists on cardiac complications following head and neck free flaps.DesignA retrospective review was performed on patients that underwent free flap reconstruction from 2012 to 2015.Results368 flaps were performed. 12.5% of patients experienced a cardiac event. Hypertension, coronary artery disease, heart failure, venous thromboembolism, and anticoagulation were associated with cardiac complications. ASA class was not predictive of cardiac events. 7.6% of patients required anticoagulation, which exhibited a strong association with surgical site hematoma. Cardiac complications led to a significantly increased length of stay.ConclusionsThere is a significant rate of cardiac events in this cohort. When estimating risk, a patient's total burden of comorbidities is more important than any one factor. ASA Class fails to demonstrate utility in this setting. Cardiac events have implications for quality-related metrics including length of stay and hematoma rate.



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