Why the study?
What are the determinants affecting early and long-term mortality in patients undergoing combined aortic valve replacement and coronary artery bypass graft surgery?
What are the determinants affecting early and long-term mortality in patients undergoing combined aortic valve replacement and coronary artery bypass graft surgery?
In patients undergoing combined aortic valve replacement and coronary artery bypass grafting, age, low LVEF, renal dysfunction, and urgent operation are the most important predictors of late mortality.
May inform risk stratification after combined AVR+CABG; leaves open whether modifying these factors improves survival.
BACKGROUND: We studied factors influencing early and late results in patients operated on for aortic valve replacement and coronary artery bypass graft. METHODS: 175 patients were retrospectively analysed over a 10-year period ending in December 2002. There were 135 males and 40 females with a mean age of 62.7 +/- 8.9 years; 109 were in NYHA class III/IV; 45 required an urgent operation, and 103 mechanical valves and 72 biological valves were implanted. RESULTS: There were 11 operative deaths (6.3 %). Statistical analysis (logistic regression) showed that previous myocardial infarction, poor NYHA class, and low LVEF had a significant effect on early death. There were 52 late deaths at a mean follow-up of 82.7 +/- 38.8 months. Using a Cox survival analysis for any causes, age, urgent operation, low LVEF, and creatinine had a strong impact on unfavourable late outcome. CONCLUSIONS: A combination of a patient-related factor (age), cardiac-related condition (low LVEF), co-morbid condition (renal dysfunction), and operative cause (urgent operation) is the most important predictor of late clinical outcome for this combined surgical procedure.
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Stassano et al. (2006) studied this question.
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