Combined operation for coronary artery bypass grafting and mitral valve replacement; risk and outcome

Introduction: The combination of mitral valve replacement (MVR) with coronary artery bypass grafting (CABG) is generally thought to have a greater early and late mortality than either procedure alone. The aim of this study is to review single center experience for the concomitant MVR and CABG. Patients and methods: This is a single center, retrospective, single cohort study, composes of consecutive cases. It included all the cases of combined operation of MVR and CABG. The patients were followed up for a median duration of two years (six months to four years). The data were collected from hospital records and registers of hospital statistics. The followings were obtained; socio-demographic data, information regarding clinical courses, intraoperative findings, and post-operative follow up data. Result: The study included 72 cases, the mean age was 56 years , 38 of them (53%) were males and 34 (47%) were female. The most common comorbidity was hypertension which was found in 24 patients (33%). The mean preoperative ejection fraction was 59%. Twenty-two patients (30.6%) had single graft, 21 patients (29.2%) underwent 3-vessel grafting, 16 patients (22.2%) had 2-vessel grafting, and 13 cases (18.1%) underwent 4-vessel grafting. The CPB duration ranged from 108 to 280 min with a mean of 182 min and cross-clamp time ranged from 80 to 186 min with a mean of 122 min. The most common complication was plural effusion which occurred in 8 cases (11.1%) and managed by aspiration. Overall mortality was 8.3% (4 patients). Conclusion: CABG and chordal-sparing and posterior leaflet replacement has favorable outcome, as well as minimizes the need of redo surgery as in repair.one of the best options for CAD and sever MR. Highlights