[Management strategy for patients with coronary artery disease associated with valve disease].
BACKGROUND
The indication of combined operation of coronary artery bypass (CAB) and valve surgery is controversial.


METHODS
Between April 1992 and January 2000, 13 patients underwent a combined operation with CAB and valve replacement, and 4 patients (2 were overlapped) who had had a previous CAB underwent a reoperative valve replacement.


RESULTS
One patient who underwent AVR and reCAB 11 years after the initial CAB died. Another patient with preoperative MRSA pneumonia and received MVR and CAB died 4 months after surgery with MRSA sepsis. However, others showed an excellent post-operative course. The causes of necessitating the reoperation were: unawareness of aortic stenosis at the initial emergency CAB in 1 patient, progression of aortic stenosis in 1 patient, progression of aortic regurgitation in 1 patient, and progression of mitral regurgitation in 1 patient.


CONCLUSIONS
The results of the combined CAB and valve replacement operation were acceptable. Patients with mild-moderate valve disease should be considered as candidates for valve surgery at the time of CAB.
Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, Tochigi, Japan.
Y
Y
Okamura
Y
Y
Mochizuki
H
H
Iida
H
H
Mori
Y
Y
Yamada
K
K
Tabuchi
Y
Y
Matsushita
I
I
Shibasaki
K
K
Shimada
D000368:Aged; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies