Abstract
Background: We studied factors influencing early and late results in patients operated on for aortic valve replacement and coronary artery bypass graft. Methods: 175 patients were retrospectively analysed over a 10-year period ending in December 2002. There were 135 males and 40 females with a mean age of 62.7 ± 8.9 years; 109 were in NYHA class III/IV; 45 required an urgent operation, and 103 mechanical valves and 72 biological valves were implanted. Results: There were 11 operative deaths (6.3 %). Statistical analysis (logistic regression) showed that previous myocardial infarction, poor NYHA class, and low LVEF had a significant effect on early death. There were 52 late deaths at a mean follow-up of 82.7 ± 38.8 months. Using a Cox survival analysis for any causes, age, urgent operation, low LVEF, and creatinine had a strong impact on unfavourable late outcome. Conclusions: A combination of a patient-related factor (age), cardiac-related condition (low LVEF), co-morbid condition (renal dysfunction), and operative cause (urgent operation) is the most important predictor of late clinical outcome for this combined surgical procedure.
Key words
Aortic valve replacement - coronary bypass graft - combined procedures - mechanical valves - bioprostheses
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MD P. Stassano
Cardiac Surgery
University “Federico II”
Via Bramante 19
81100 Caserta
Italy
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