Aortic valve replacement and coronary artery surgery: determinants affecting early and long-term results.
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.
Stassano
P
P
Cardiac Surgery, University Federico II, Naples, Italy. pstassano@libero.it
Di Tommaso
L
L
Vitale
D F
DF
Monaco
M
M
Iannelli
G
G
Mottola
M
M
Musumeci
A
A
Spampinato
N
N
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000453:epidemiology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000453:epidemiology* / Q000601:surgery; D001705:Bioprosthesis; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome