Key result
Concomitant CABG during combined aortic and mitral valve replacement increased operative, bypass, and cross-clamp times and mechanical ventilation (p<0.001) without affecting ICU stay (p=0.727).
Why the study?
Comparative data on how different coronary revascularization strategies affect the intraoperative and early postoperative course during combined aortic and mitral valve replacement remain limited.
Does concomitant coronary artery bypass grafting or previous percutaneous coronary intervention affect intraoperative and early postoperative outcomes in patients undergoing combined aortic and mitral valve replacement?
Observational (n=157)
Does concomitant coronary artery bypass grafting or previous percutaneous coronary intervention affect intraoperative and early postoperative outcomes in patients undergoing combined aortic and mitral valve replacement?
In patients undergoing combined aortic and mitral valve replacement, concomitant CABG prolongs intraoperative times, increases blood loss, and extends mechanical ventilation without extending ICU stay compared to prior PCI or isolated valve replacement.
Answers are grounded in this paper and cite their sources.
May inform revascularization choice during combined valve surgery; leaves open need for prospective trials before practice change.
Introduction. Combined aortic and mitral valve defects are among the most complex forms of valvular heart disease and are characterized by progression of heart failure, myocardial remodeling, and a high risk of adverse cardiovascular events. Comparative data on the impact of different coronary revascularization strategies on the intraoperative and early postoperative course in patients with combined aortic and mitral valve replacement remain limited. Combined aortic and mitral valve disease associated with coronary artery disease requires an appropriate myocardial revascularization strategy during surgical treatment. Objective. To evaluate the impact of concomitant coronary artery bypass grafting and previous percutaneous coronary intervention on intraoperative outcomes during combined aortic and mitral valve replacement. Materials and methods. A retrospective study included 157 patients divided into three groups according to the presence of coronary artery disease and the selected revascularization strategy: concomitant coronary artery bypass grafting, previous percutaneous coronary intervention, or isolated combined valve replacement. Results. Concomitant coronary artery bypass grafting was associated with significantly longer operative time, cardiopulmonary bypass time, and aortic cross-clamp time (p<0.001), as well as greater intraoperative blood loss (p=0.007) and prolonged mechanical ventilation (p<0.001). No significant differences were observed in the duration of intensive care unit stay (p=0.727). Conclusions. Concomitant coronary artery bypass grafting increases the duration of the intraoperative stage but does not adversely affect the early postoperative course.
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Hutsuliak et al. (2026) conducted an observational in Combined aortic and mitral valve disease (n=157). Concomitant coronary artery bypass grafting (CABG) vs. Previous percutaneous coronary intervention (PCI) or isolated combined valve replacement was evaluated on Intraoperative and early postoperative outcomes (operative time, cardiopulmonary bypass time, aortic cross-clamp time, intraoperative blood loss, mechanical ventilation duration, and ICU stay) (p=<0.001). Concomitant CABG during combined aortic and mitral valve replacement increased operative, bypass, and cross-clamp times and mechanical ventilation (p<0.001) without affecting ICU stay (p=0.727).
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