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[Combined valvular and coronary artery surgery]
S Hamanaka1, T Hata, Y Tsushima
1Depatment of Cardiovascular Surgery, Sakakibara Hospital, Okayama, Japan.
Insights
Combined heart surgery for valve and coronary artery disease is safe and effective. This study shows low operative risk and favorable long-term outcomes for patients undergoing this complex procedure.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Surgery
- Coronary Artery Bypass Grafting
Context:
- The study evaluated 78 patients who underwent combined valvular and coronary artery operations between 1990 and 1999.
- Patients presented with various valve conditions, including aortic (49), mitral (23), and combined aortic and mitral (6) diseases.
- The average patient age was 67 years, with 12 patients having a history of myocardial infarction.
Purpose:
- To assess the operative risk and long-term outcomes of combined valvular and coronary artery surgery.
- To evaluate the safety and efficacy of performing both valve repair/replacement and coronary artery bypass grafting simultaneously.
Summary:
- An average of 1.82 grafts per patient were inserted, with 0.96 being arterial grafts.
- Graft placement was predominantly performed before valve intervention, utilizing coronary perfusion through free grafts to minimize myocardial ischemia.
- The study reported a low preoperative mortality rate of 1.3% and an excellent event-free ratio of 95% at a mean follow-up of 42 months.
Impact:
- The findings suggest that combined valvular and coronary artery surgery carries a generally low operative risk.
- The procedure demonstrates favorable long-term results, indicating its clinical value for selected patients.
- This research supports the viability of combined surgical approaches for complex cardiac conditions.
Abstract:
Between 1990 and 1999, 78 patients underwent combined valvular coronary artery operation. Aortic valve disease was present in 49 patients, mitral valve disease in 23 patients, aortic and mitral valve disease in 6 patients. The average age was 67 years. Twelve patients had had a previous myocardial infarction. The average number of grafts inserted was 1.82 per patients, and the average number of artery grafts inserted was 0.96 per patients. The most number of grafts were placed prior to valve replacement or plasty. And periods of myocardial ischemia were kept at a minimum by coronary perfusion through free grafts. Preoperative mortality was 1.3%. And event fee ratio after operation was 95% (mean follow up 42 month). Therefore the operative risk of combined surgery is, in general, low and the long term results are favorable.