[Valvular surgical treatment concurrent with myocardial revascularization].
OBJECTIVE
To study the morbidity and mortality due to valvar surgical treatment performed concomitantly to myocardial revascularization.


METHODS
From 1650 patients submitted to mitral or aortic valve surgical treatment, 103 (6.24%) had it associated to myocardial revascularization. Coronary insufficiency was associated to aortic valvar lesion in 66 (64.0%) patients, group I, with mean age of 62.3 +/- 8 years; and in 37 (35.9%) patients with mitral valve lesion, group II, with mean age of 57.8 +/- 5.8 years. Diagnosis was based upon the anamnesis, physical examination and confirmed by cine-coronarographic findings.


RESULTS
I-Complications at the immediate postoperative; a) mortality 11 (10.6%) patients, 6 (9.09%) from group I: by low cardiac output 3, uncontrolled arrhythmia 1, mediastinitis 1; acute infarction with cardiogenic shock 1, and 5 (134.5%) of group II: uncontrolled hemorrhage 2, sudden death 1, saphenous vein graft occlusion, respiratory insufficiency and sepsis 2; b) controlled intercurrences that increased the time of hospitalization: mental disorder 5 patients; CVA 7, diabetes decompensation 2, worsening of chronic renal insufficiency 1, upper level digestive hemorrhage 1 and respiratory insufficiency 3 patients. II-late postoperative complications of 77 (83.6%) patients which could be followed up during a period of 60 months: 1) mortality: 3 (3.89%) patients; 2 due to cardiomyopathy and 1 by acute myocardial infarction; 2) late evolution-functional capacity III (NYHA) by cardiomyopathy 6; I/II 68 patients; mild angina 6 patients, 2 underwent revascularization at the end of final 36-42 months.


CONCLUSIONS
The clinical improvement and mortality indexes statistically similar to the isolate surgical acts stimulate us to keep up with such associate procedures.
Lavítola
P de L
Pde L
Instituto do Coração, Hospital das Clínicas, FMUSP.
Dallan
L A
LA
Tarasoutchi
F
F
Grinberg
M
M
da Luz
P L
PL
Pileggi
F
F
Jatene
A D
AD
D000328:Adult; D000368:Aged; D001021:Aortic Valve; D001705:Bioprosthesis / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D009204:Myocardial Revascularization / Q000706:statistics & numerical data
Tratamento cirúrgico valvar concomitante à revascularização do miocárdio.