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Myocardial revascularization combined with aortic valve replacement.
R V Pellegrini1, T Kowalsky, A G Marrangoni
1Department of Thoracic Cardiovascular Surgery and Surgical Research Laboratory, Mercy Hospital, Pittsburgh, Pennsylvania 15219, USA.
Texas Heart Institute Journal
|September 1, 1986
Summary
This study shows that combining coronary artery bypass grafting with aortic valve replacement is safe and effective. Hypothermic blood cardioplegia offers superior myocardial protection for patients with severe coronary and aortic valve disease.
Area of Science:
- Cardiovascular Surgery
- Cardiac Anesthesia
Background:
- Aortic valve disease and coronary artery disease often coexist.
- Surgical management requires careful consideration of both conditions.
Purpose of the Study:
- To evaluate the safety and efficacy of combined myocardial revascularization and aortic valve replacement.
- To assess the effectiveness of hypothermic blood cardioplegia in this patient population.
Main Methods:
- Retrospective review of 50 consecutive patients undergoing combined procedures.
- Utilized a cold blood cardioplegia technique for myocardial protection.
- Average of 2.3 coronary arteries grafted per patient.
Main Results:
- Low hospital mortality (2 deaths).
- Low perioperative and late myocardial infarction rates.
- Average follow-up of 16 months.
Conclusions:
- Hypothermic blood cardioplegia provides uniform myocardial protection, particularly in hypertrophied ventricles.
- Combined myocardial revascularization and aortic valve replacement is a recommended strategy for patients with concurrent disease.