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Updated: May 22, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
[Aortic valve replacement and concomitant coronary artery bypass: assessing the morbi-mortality and recent outcomes]
Vera Peixoto1, Miguel Guerra, Armando Almeida
1Escola de Ciencias da Saúde, Universidade do Minho e Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova de Gaia÷Espinho, EPE.
Insights
Combined aortic valve replacement and coronary artery bypass grafting (AVR-CABG) is effective for high-risk patients, showing low complication and mortality rates. Preoperative comorbidities significantly impact outcomes in these complex cardiac surgeries.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Perioperative Risk Assessment
Abstract:
Combined coronary artery bypass and aortic valve replacement ( AVR-CABG ) carries increased perioperative risk, and tends to have higher-risk patients. The impact of pre-operative comorbidities on outcomes after AVR-CABG has not been sufficiently evaluated. The purpose of the present study was to analyze risk factors, concomitant diseases, postoperative complications and mortality rate in patients undergoing AVR-CABG. We retrospectively reviewed all patients who underwent AVR-CABG ( n=115, 8.2 % ) at our institution between June 2008 and June 2011 ( total=1399 ). The average age was 72.8±0.7 years-old and 66.1 % were male. Preoperative risk factors were: arterial hypertension ( 80.0 % ), diabetes ( 34.8 % ), dyslipidemia ( 74.8 % ), smoking ( 19.1 % ), renal failure ( 10.4 % ), chronic obstructive pulmonary disease ( 6.1 %) and arterial disease ( 17.4 % ). Presenting diagnosis was severe aortic stenosis in 73.9 % and acute coronary syndrome in the remaining.Biological valves were implanted in 90.4 % patients and 69.6 %patients received only one aorto-coronary bypass. The stay in hospital was 9,4±0,6 days. The most important complications were: postoperative bleeding ( 6.1 % ), mediastinitis ( 5.2 % ), heart failure ( 5.2 % ), pulmonary insufficiency ( 5.2 % ) and acute renal failure ( 7.0 % ). Operative mortality was 2.6 %.Our results suggest that AVR-CABG is an effective treatment associated with low rates of morbimortality, although presented to higher-risk patients.
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