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Combined Degenerative Mitral Valve and Coronary Surgery: Early Outcomes and 10-Year Survival

Vito D Bruno1, Mustafa Zakkar1, Gustavo Guida1

  • 1Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom.

The Annals of Thoracic Surgery
|April 12, 2020
PubMed

Insights

Combined degenerative mitral valve (DMV) and coronary artery bypass grafting (CABG) surgery shows similar outcomes to DMV surgery alone. Mitral valve repair in combined procedures improves long-term survival.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Disease
  • Coronary Artery Disease

Background:

  • Degenerative mitral valve (DMV) disease is a common cardiac condition.
  • Coronary artery disease (CAD) often coexists with DMV disease.
  • The optimal surgical approach for patients with both conditions requires investigation.

Purpose of the Study:

  • To compare the impact of combined coronary artery bypass grafting and degenerative mitral valve surgery (CABG+DMV) versus degenerative mitral valve surgery only (DMV-only).
  • To evaluate in-hospital outcomes and 10-year survival rates for these surgical approaches.
  • To assess the role of mitral valve repair in long-term survival.

Main Methods:

  • A retrospective analysis of 745 patients with DMV disease.
  • Comparison of 186 patients undergoing CABG+DMV surgery with 559 patients undergoing DMV-only surgery.
  • Propensity score-matching analysis to minimize bias and evaluate short-term composite outcomes and 10-year survival.

Main Results:

  • Combined CABG+DMV surgery demonstrated similar in-hospital composite endpoint rates compared to DMV-only surgery in both unmatched and matched analyses.
  • Ten-year survival rates were comparable between the combined surgery group and the DMV-only group.
  • Mitral valve repair was associated with improved short-term outcomes and long-term survival, irrespective of concomitant coronary surgery.

Conclusions:

  • Combined CABG+DMV surgery is an effective treatment option for patients with concomitant coronary and degenerative mitral valve disease.
  • Early and long-term survival outcomes are comparable between combined surgery and DMV-only surgery.
  • Mitral valve repair is a critical factor for enhancing long-term survival in patients undergoing combined procedures.
Abstract

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