Aortic Valve Replacement and Coronary Artery Surgery: Determinants Affecting Early and Long-Term Results (original) (raw)

Thorac Cardiovasc Surg 2006; 54(8): 521-527
DOI: 10.1055/s-2006-924467

Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

P. Stassano1 , L. Di Tommaso1 , D. F. Vitale2 , M. Monaco1 , G. Iannelli1 , M. Mottola1 , A. Musumeci1 , N. Spampinato1

• 1Cardiac Surgery, University “Federico II”, Naples, Italy
• 2Fondazione Salvatore Maugeri, IRCCS, Telese Terme, Italy

Further Information

Publication History

Received March 2, 2006

Publication Date:
06 December 2006 (online)

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”

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