Why the study?
To analyze the early postoperative outcomes of surgical aortic valve replacement combined with endovascular versus surgical methods of myocardial revascularization.
Does percutaneous coronary intervention (PCI) prior to surgical aortic valve replacement (SAVR) improve early postoperative outcomes compared to concomitant SAVR and coronary artery bypass grafting (CABG) in patients with aortic valve pathology and ischemic heart disease?
Does percutaneous coronary intervention (PCI) prior to surgical aortic valve replacement (SAVR) improve early postoperative outcomes compared to concomitant SAVR and coronary artery bypass grafting (CABG) in patients with aortic valve pathology and ischemic heart disease?
In patients requiring surgical aortic valve replacement and myocardial revascularization, performing PCI prior to SAVR is associated with shorter operative times and less postoperative bleeding compared to concomitant SAVR and CABG, with comparable early safety outcomes.
Combined SAVR-revascularization outcomes in this retrospective cohort should not guide practice; leaves open need for prospective trials on optimal strategies.
The aim – to analyze the results of the early postoperative period of surgical aortic valve replacement (SAVR) combined with endovascular or surgical methods of myocardial revascularization.Materials and methods. For this retrospective study, a selection of medical records of adult patients (over 18 years of age) who underwent SAVR concomitant with myocardial revascularization in the period from 2018 to 2022 was carried out.Results and discussion. We selected 95 patients who were treated with SAVR with concomitant myocardial revascularization (the first group (n = 31) – a combination of SAVR and percutaneous coronary intervention (PCI); the second group (n = 48) – a combination of SAVR and CABG). In patients of the first group, lesions of the main left coronary artery and the circumflex artery were recorded, respectively, by 24.85 % (p = 0.011) and by 23.7 % (p = 0.033) less often. Moreover, the patients of the first group required intraoperative use of more than two doses of blood red cell mass by 21.4 % less often (p = 0.046). In the early postoperative period, a lower level of bleeding was observed in patients of the first group compared to the second group (180 (150; 250) ml vs. 250 (200; 305) ml, p = 0.008).Conclusions. Patients who underwent PCI before SAVR were characterized by a shorter duration of surgery, cardiopulmonary bypass, and aortic cross-clamping, while no significant difference in major early postoperative complications was observed between the study groups.
No takes yet. Share an insight, caveat, or question.
Boyko et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: