title: [Aortic valve replacement and concomitant coronary artery bypass: assessing the morbi-mortality and recent outcomes].
abstract: Combined coronary artery bypass and aortic valve replacement ( AVR-CABG ) carries increased perioperative risk, and tends to have higher-risk patients. The impact of pre-operative comorbidities on outcomes after AVR-CABG has not been sufficiently evaluated. The purpose of the present study was to analyze risk factors, concomitant diseases, postoperative complications and mortality rate in patients undergoing AVR-CABG. We retrospectively reviewed all patients who underwent AVR-CABG ( n=115, 8.2 % ) at our institution between June 2008 and June 2011 ( total=1399 ). The average age was 72.8±0.7 years-old and 66.1 % were male. Preoperative risk factors were: arterial hypertension ( 80.0 % ), diabetes ( 34.8 % ), dyslipidemia ( 74.8 % ), smoking ( 19.1 % ), renal failure ( 10.4 % ), chronic obstructive pulmonary disease ( 6.1 %) and arterial disease ( 17.4 % ). Presenting diagnosis was severe aortic stenosis in 73.9 % and acute coronary syndrome in the remaining.Biological valves were implanted in 90.4 % patients and 69.6 %patients received only one aorto-coronary bypass. The stay in hospital was 9,4±0,6 days. The most important complications were: postoperative bleeding ( 6.1 % ), mediastinitis ( 5.2 % ), heart failure ( 5.2 % ), pulmonary insufficiency  ( 5.2 % ) and acute renal failure ( 7.0 % ). Operative mortality was 2.6 %.Our results suggest that AVR-CABG is an effective treatment associated with low rates of morbimortality, although presented to higher-risk patients.
authors.affiliation: Escola de Ciencias da Saúde, Universidade do Minho e Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova de Gaia÷Espinho, EPE.
authors.forename: Vera
authors.initials: V
authors.lastname: Peixoto
authors.forename: Miguel
authors.initials: M
authors.lastname: Guerra
authors.forename: Armando
authors.initials: A
authors.lastname: Almeida
authors.forename: José
authors.initials: J
authors.lastname: Cascarejo
authors.forename: Luis
authors.initials: L
authors.lastname: Vouga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001026:Coronary Artery Bypass; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome