title: Aortic valve replacement and coronary artery surgery: determinants affecting early and long-term results.
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.
authors.affiliation: Cardiac Surgery, University Federico II, Naples, Italy. pstassano@libero.it
authors.forename: P
authors.initials: P
authors.lastname: Stassano
authors.forename: L
authors.initials: L
authors.lastname: Di Tommaso
authors.forename: D F
authors.initials: DF
authors.lastname: Vitale
authors.forename: M
authors.initials: M
authors.lastname: Monaco
authors.forename: G
authors.initials: G
authors.lastname: Iannelli
authors.forename: M
authors.initials: M
authors.lastname: Mottola
authors.forename: A
authors.initials: A
authors.lastname: Musumeci
authors.forename: N
authors.initials: N
authors.lastname: Spampinato
mesh_terms: 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