Impact of concomitant coronary artery bypass grafting on in-hospital outcome in octogenarians undergoing aortic valve

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Shahzad G Raja1, Manoraj Navaratnarajah, Mubassher Husain

  • 1Department of Cardiac Surgery, Harefield Hospital, London, United Kingdom. drrajashahzad@hotmail.com

The Journal of Heart Valve Disease
|June 27, 2013
PubMed

Insights

In octogenarians, combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) show similar in-hospital outcomes to isolated AVR. This supports the combined procedure in carefully selected elderly patients.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Cardiology
  • Cardiac Surgery Outcomes

Background:

  • Surgical aortic valve replacement (AVR) in octogenarians has excellent in-hospital outcomes.
  • Limited data exists on concomitant AVR and coronary artery bypass grafting (CABG) outcomes in this age group.
  • This study compares in-hospital outcomes of combined AVR and CABG versus isolated AVR in octogenarians.

Purpose of the Study:

  • To compare the in-hospital outcomes of concomitant AVR and CABG versus isolated AVR in octogenarians.
  • To evaluate the safety and efficacy of combined cardiac procedures in elderly patients.
  • To provide evidence for decision-making in high-risk cardiac surgery patients.

Main Methods:

  • Retrospective analysis of a prospectively collected cardiac surgery database.
  • Comparison of 114 octogenarians undergoing AVR + CABG with 68 octogenarians undergoing isolated AVR.
  • Review of medical notes and charts for detailed outcome assessment.

Main Results:

  • Both groups had similar mean age, demographics, and EuroSCORE.
  • Longer aortic cross-clamp and cardiopulmonary bypass times were observed in the AVR + CABG group.
  • In-hospital mortality was comparable (7.4% vs. 9.6%), with a higher need for hemofiltration in the AVR + CABG group.

Conclusions:

  • Concomitant AVR and CABG in octogenarians yield in-hospital outcomes comparable to isolated AVR.
  • The combined procedure is justified in carefully selected high-risk elderly patients.
  • This finding supports the consideration of combined AVR and CABG for eligible octogenarians.
Abstract

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