What question did this study set out to answer?

June 1, 1983Annals of SurgeryOpen Access

Combined Aortic Valve Replacement And Myocardial Revascularization

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Why the study?

Does combined aortic valve replacement and coronary artery bypass grafting using cold cardioplegia improve outcomes in patients with coexisting aortic valvular and coronary artery disease?

Population

54 consecutive patients with coexisting aortic valvular and coronary artery disease requiring valve…

Design

Cohort

Follow-up

up to 65 months

Authors

NKNicholas T. KouchoukosInterventional / Structural Cardiology WLWilliam A. LellUniversity of Alabama at Birmingham WRWilliam J. RogersGeneral Cardiology

Discussion

Member takes

Implication

Supports combined AVR+CABG with cold cardioplegia in suitable patients; hypothesis-generating and leaves open need for randomized comparisons.

Key Points

To assess patient outcomes following combined aortic valve replacement and coronary artery bypass grafting using standardized cold cardioplegic myocardial protection.
Retrospective review of 54 consecutive patients who underwent combined aortic valve replacement and coronary artery bypass grafting over a 5-year interval ending May 1982.
Myocardial protection was achieved using a standardized cold cardioplegic technique, with a mean of 2.4 coronary arteries grafted per patient.
Patient survival and cardiac events were tracked over a follow-up period extending up to 65 months.
In-hospital mortality was 1.9% (1 of 54 patients), perioperative myocardial infarction occurred in 1.9% (1 of 54 patients), and 1 patient required postoperative intra-aortic balloon pump support.
Actuarial 3-year survival was 87% overall, reaching 95% in patients with aortic stenosis compared to 65% in those with aortic regurgitation or mixed lesions.
Over up to 65 months of follow-up, there were 4 late deaths, zero cardiac-related deaths among patients with aortic stenosis, and 1 non-fatal myocardial infarction.

Structured PICO

Does combined aortic valve replacement and coronary artery bypass grafting using cold cardioplegia improve outcomes in patients with coexisting aortic valvular and coronary artery disease?

Population

54 consecutive patients with coexisting aortic valvular and coronary artery disease requiring valve replacement. Calcific aortic stenosis was the most common indication. 37 patients (69%) had greater than 50-60% stenoses in at least two of the three major coronary arterial systems.

Intervention

Combined aortic valve replacement and coronary artery bypass grafting using a standardized cold cardioplegic technique for intraoperative myocardial protection.

Outcome

Hospital death and survival at 3 yearshard clinical

Combined aortic valve replacement and coronary artery bypass grafting using cold cardioplegia is safe and provides excellent mid-term survival, particularly for patients with aortic stenosis.

Cite This Study

Kouchoukos et al. (1983) studied this question.

synapsesocial.com/papers/6a7eac9a4fe759ebdc8ec321 https://doi.org/10.1097/00000658-198306000-00011

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Implication

Supports combined AVR+CABG with cold cardioplegia in suitable patients; hypothesis-generating and leaves open need for randomized comparisons.

Combined Aortic Valve Replacement And Myocardial Revascularization

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Combined Aortic Valve Replacement And Myocardial Revascularization

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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