title: Operative treatment of combined aortic stenosis and coronary artery disease.
abstract: BACKGROUND
  The aortic valve replacement is a standard operating procedure in patients with severe aortic stenosis. Structure of patients undergoing surgery ranges from young population with isolated mitral valvular disease to the elderly population, which is in addition to the underlying disease additionally burdened with comorbidity. One of the most commonly present factors that further complicate the surgery is coronary heart disease that occurs in, almost, one third of patients with aortic stenosis. The aim is to compare the results of surgery for aortic valve replacement with or without coronary artery bypass graft (CABG).
  
  
  METHODS
  From August 2008 to January 2013 in our center operated on 120 patients for aortic stenosis. Of this number, 75 were men and 45 women. The average age was 63.37 years (16-78). Isolated aortic valve replacement was performed in 89 patients and in 31 patients underwent aortic valve replacement and coronary bypass surgery. Implanted 89 biological and 31 mechanical valves.
  
  
  RESULTS
  Patients with associated aortic stenosis and coronary artery disease were more expressed symptomatic symptoms preoperatively to patients with isolated aortic stenosis who were on average younger age. Intra-hospital morbidity and mortality was more pronounced in the group of patients with concomitant aortic valve replacement and coronary bypass surgery. Morbidity was recorded in 17 patients (14.3%) in both groups, while the mortality rate in both groups was 12 patients (10.1%).
  
  
  CONCLUSIONS
  Evaluation of preoperative risk factors and comorbidity in patients with aortic stenosis and coronary artery disease contributes to a significant reduction in intraoperative and postoperative complications. Also, early diagnosis of associated coronary artery disease and aortic stenosis contributes to timely decision for surgery thus avoiding subsequent ischaemic changes and myocardial damage.
authors: Center for the Heart BH, Department of Cardiovascular Surgery, Tuzla, Bosnia and Herzegovina.
authors: Nedzad
authors: N
authors: Kadric
authors: Center for the Heart BH, Department of Cardiovascular Surgery, Tuzla, Bosnia and Herzegovina.
authors: Emir
authors: E
authors: Kabil
authors: Center for the Heart BH, Department of Cardiovascular Surgery, Tuzla, Bosnia and Herzegovina.
authors: Emir
authors: E
authors: Mujanovic
authors: Center for the Heart BH, Department of Cardiovascular Surgery, Tuzla, Bosnia and Herzegovina.
authors: Mehdin
authors: M
authors: Hadziselimovic
authors: Center for the Heart BH, Department of Cardiovascular Surgery, Tuzla, Bosnia and Herzegovina.
authors: Mirza
authors: M
authors: Jahic
authors: Center for the Heart BH, Department of Cardiovascular Surgery, Tuzla, Bosnia and Herzegovina.
authors: Stojan
authors: S
authors: Rajkovic
authors: Center for the Heart BH, Department of the Cardiology, Tuzla, Bosnia and Herzegovina.
authors: Enes
authors: E
authors: Osmanovic
authors: Center for the Heart BH, Department of the Cardiology, Tuzla, Bosnia and Herzegovina.
authors: Sevleta
authors: S
authors: Avdic
authors: Center for the Heart BH, Department of Anesthesiology, Tuzla, Bosnia and Herzegovina.
authors: Suad
authors: S
authors: Keranovic
authors: Center for the Heart BH, Department of Anesthesiology, Tuzla, Bosnia and Herzegovina.
authors: Adnan
authors: A
authors: Behrem
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001024:Aortic Valve Stenosis / Q000601:surgery*; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
keywords: Aortic stenosis; coronary artery disease; operative treatment