title: Is the aortic valve pathology type different for early and late mortality in concomitant aortic valve replacement and coronary artery bypass surgery?
abstract: We assessed the effects of aortic valve pathology type on the long-term outcomes of patients who underwent concomitant aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) surgery. We retrospectively reviewed 150 patients who underwent AVR-CABG at our institution between January 1997 and December 2006. We divided patients into aortic stenosis (AS), aortic regurgitation (AR), and mixed-type groups consisting of 98 (65.3%), 20 (13.3%) and 32 (21.3%) patients, respectively. The AS group had more female patients, a higher mean angina class, older mean patient age, increased history of previous myocardial infarction (MI), and smaller valve size compared to other groups. No significant differences were observed among groups in the operative mortality for five or ten-year survival rates. Significant early mortality risk factors included cross-clamp and cardiopulmonary bypass (CBP) time, number of blood transfusion units, chronic obstructive pulmonary disease (COPD), intra-aortic balloon pump (IABP), inotropic drugs, and pacemaker use. Significant late mortality risk factors included intensive care unit (ICU) stay, IABP, stroke, and dialysis. The aortic valve pathology type in patients undergoing concomitant AVR-CABG does not adversely affect survival.
authors.affiliation: Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. rafetgunay@hotmail.com
authors.forename: Rafet
authors.initials: R
authors.lastname: Gunay
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Sensoz
authors.forename: Ilyas
authors.initials: I
authors.lastname: Kayacioglu
authors.forename: Abdullah Kemal
authors.initials: AK
authors.lastname: Tuygun
authors.forename: Ahmet Yavuz
authors.initials: AY
authors.lastname: Balci
authors.forename: Ugur
authors.initials: U
authors.lastname: Kisa
authors.forename: Mahmut Murat
authors.initials: MM
authors.lastname: Demirtas
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yekeler
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D006305:Health Status Indicators; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome