[Combined valvular and coronary artery surgery (author's transl)]

Between January 1st, 1976 and October 31st, 1978 ten patients underwent simultaneour replacement or repair of a cardiac valve and coronary revascularization surgery. Six patients age ranged within 45 and 66 years presented mitral insufficiency, subsequent to myocardial infarction in five and rheumatic disease in one. Aortic valvular disease was present in four patients, it was atherosclerotic in three and congenital in one. All patients had both symptoms and signs of coronary insufficiency. Fifteen aortocoronary bypass grafts were inserted. Five mitral valve and four aortic valve replacements were performed; one patient underwent mitral valve annuloplasty. Best results were achieved in the aortic group, in which no deaths occurred; three deaths occurred in the mitral group. At the follow-up evaluation (average 14.2 months) all but one surviving patients showed marked symptomatic improvement, having moved to the upper functional class. The frequent incidence of coronary occlusive disease in patients with valvular heart disease recommends extensive use of selective coronary arteriography in preoperative evaluation. Simultaneous repair of all significant heart lesions is recommended.