Key result
Combined valve surgery and coronary artery bypass grafting was associated with a 3-fold increase in 30-day mortality (18.6% vs 6.2%, p=0.001) compared to isolated valve surgery.
Why the study?
The study was conducted to evaluate the impact of additional coronary revascularization on early results in patients undergoing valve surgery.
Does additional coronary artery bypass grafting increase 30-day mortality in patients requiring valve surgery compared to isolated valve surgery?
Cohort (n=1,667)
Yes
Does additional coronary artery bypass grafting increase 30-day mortality in patients requiring valve surgery compared to isolated valve surgery?
Relative Risk: 3
Absolute Event Rate: 18.6% vs 6.2%
p-value: p=0.001
Combined valve+CABG surgery associated with higher 30-day mortality; leaves open whether added revascularization or comorbidities drive risk in this observational cohort.
Background: The aim of this study was to evaluate the impact of additional coronary revascularization on the early results in patients submitted to valve surgery. Patients and Methods: A retrospective review of the cardiac surgical database between January 2000 and December 2018 was performed. A total of 1667 patients were included and divided into two groups: Group A isolated valve surgery (IVS n = 1608) and Group B with valve surgery combined to coronary artery bypass grafting (VS + CABG n = 59). Demographic, operative data and postoperative outcomes were compared between groups. Results: Patients with combined procedure were older than patients who underwent isolated valvular surgery (64.9 ± 9.2 years vs 44.4 ± 13.1 years; p = 0.0001) and there was a higher proportion of diabetics (40.7% vs 6.6%; p = 0.0001). The 30 days mortality rate in the combined procedure group was 18.6% versus 6.2% in isolated valve surgery (p = 0.001). Also post-operative complications were more frequent than for patients who underwent IVS. Additionally we noted a high prevalence of coronary artery risk factors in patients with combined procedures. Conclusion: Surgical mortality and morbidity of coexisting coronary and heart valve disease were substantially higher than IVS. More efforts in medical management may reduce the incidence of adverse outcomes.
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Benyoussef et al. (2019) conducted a cohort in Valvular heart disease (n=1,667). Valve surgery combined with coronary artery bypass grafting (VS + CABG) vs. Isolated valve surgery (IVS) was evaluated on 30 days mortality (RR 3.0, p=0.001). Combined valve surgery and coronary artery bypass grafting was associated with a 3-fold increase in 30-day mortality (18.6% vs 6.2%, p=0.001) compared to isolated valve surgery.
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