title: First-time, isolated surgical aortic valve replacement after prior coronary artery bypass surgery: results from the RECORD multicenter registry.
abstract: BACKGROUND
  This multicenter study was undertaken to determine the immediate and long-term outcomes in patients undergoing a primary surgical aortic valve replacement (AVR) who had a previous coronary artery bypass graft surgery with patent grafts.
  
  
  METHODS
  One hundred and thirteen consecutive patients (mean EuroSCORE II, 10.3 ± 7.7%, median 8.0%) who underwent first-time isolated AVR after coronary artery bypass grafting (CABG) were the subjects of this multicenter study. The procedure was performed through a full sternotomy in 95.7% of cases, a patent internal mammary artery graft was clamped in 76.6% of patients. The temperature of cardioplegia was ≤12 °C in 62.8% of patients and systemic temperature was <32 °C in 23.9% of patients.
  
  
  RESULTS
  Thirty-day mortality was 4.4%. Stroke was observed in 8.0% of patients, low cardiac output syndrome in 14.1%, prolonged tracheal intubation in 20.8%, and intensive care unit stay was longer than five days in 19.5% of patients. Among patients with a patent internal mammary graft (91 patients), clamping of this graft (5.7% vs. 0%, p = 0.57) was associated with a nonsignificant trend toward increased 30-day mortality. One-, three- and five-year survival rates were 91.5%, 90.4%, and 88.4%, respectively.
  
  
  CONCLUSIONS
  Patients undergoing isolated AVR after prior CABG have a good immediate and late survival. A history of prior CABG should not be considered an absolute indication for transcatheter AVR.
authors.affiliation: Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.forename: Francesco
authors.initials: F
authors.lastname: Onorati
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mariscalco
authors.forename: Marisa
authors.initials: M
authors.lastname: De Feo
authors.forename: Antonio
authors.initials: A
authors.lastname: Messina
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santarpino
authors.forename: Francesco
authors.initials: F
authors.lastname: Santini
authors.forename: Cesare
authors.initials: C
authors.lastname: Beghi
authors.forename: Ester
authors.initials: E
authors.lastname: Della Ratta
authors.forename: Giovanni
authors.initials: G
authors.lastname: Troise
authors.forename: Theodor
authors.initials: T
authors.lastname: Fischlein
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Passerone
authors.forename: Tatu
authors.initials: T
authors.lastname: Juvonen
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mazzucco
authors.forename: Jouni
authors.initials: J
authors.lastname: Heikkinen
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Faggian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D003250:Constriction; D001026:Coronary Artery Bypass; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D012042:Registries; D056346:Sternotomy; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome