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[Combined operation for ischemic heart diseases and valvular heart diseases]
1Department of Cardiovascular Surgery, Hiroshima City Hospital, Japan.
Insights
Combined surgery for ischemic and valvular heart disease is safe in select patients. Careful attention to arteriosclerotic lesions is crucial for successful outcomes in these complex cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Heart Disease Treatment
Context:
- Combined surgical procedures address complex cardiac conditions.
- Patients with both ischemic heart disease and valvular heart disease present unique challenges.
- This study analyzes outcomes of combined operations performed between 1991 and 1999.
Purpose:
- To evaluate the safety and outcomes of combined surgical interventions for patients with concurrent ischemic and valvular heart disease.
- To determine the feasibility of performing coronary artery bypass grafting alongside valvular heart surgery.
- To identify potential risks and necessary precautions for combined cardiac operations.
Summary:
- Twenty-one patients underwent combined operations for ischemic and valvular heart disease.
- Procedures included coronary artery bypass grafting, aortic valve replacement, mitral valve replacement, and mitral valve plasty.
- Associated aortic surgeries were performed in three cases, with a 14.3% mortality rate attributed to complications like aortic rupture and cerebral infarction.
Impact:
- Combined cardiac surgery can be performed safely in carefully selected patients.
- The findings highlight the importance of meticulous management of arteriosclerotic lesions.
- This study contributes to understanding the risks and benefits of complex cardiac surgical strategies.
Abstract:
We performed combined operation for patients who have both ischemic heart disease and valvular heart disease in 21 cases from January 1991 to October 1999. This operation was 3.1% of 682 cases of coronary artery bypass grafting and 5.0% of 416 cases of operation for valvular heart disease during that period. The mean age of these patients was 67.9 +/- 9.1 years. The average number of grafts in the coronary artery bypass grafting was 1.5 +/- 0.6. Aortic valve replacement was performed in 6 cases, mitral valve replacement in 10 cases and mitral valve plasty in 5 cases. Together with this combined operation, ascending aorta and aortic arch replacement was done in 1 case and abdominal aortic replacement in 2 cases. Three patients died due to postoperative aortic rupture, cerebral infarction or excessive surgical intervention in ascending aorta and aortic arch replacement. Combined operation for ischemic heart diseases and valvular heart diseases can safely performed, but it appears necessary to pay attention to arteriosclerotic lesions.