title: Outcomes of a Combined Approach of Percutaneous Coronary Revascularization and Cardiac Valve Surgery.
abstract: A subset of patients requiring coronary revascularization and valve surgery may benefit from a combined approach of percutaneous coronary intervention (PCI) and valve surgery, as opposed to the standard median sternotomy approach of combined coronary artery bypass and valve surgery. To evaluate its potential benefits and limitations, a literature search was performed using PubMed, EMBASE, Ovid, and the Cochrane library, through March 2016 to identify all studies involving a combined approach of PCI and valve surgery in patients with coronary artery and valvular disease. There were five studies included in the study with a total of 324 patients, of which 75 (23.1%) had a history of previous cardiac surgery. The interval between PCI and surgery ranged from simultaneous intervention to a median of 38 days (interquartile range, 18-65 days). The surgical approach performed consisted of a minimally invasive one or median sternotomy. There were 275 single valve surgery (84.9%) and 49 double-valve surgery (15.1%) with a 30-day mortality ranging from 0% to 5.5%. The 1-year survival ranged from 78% to 96%, and the follow-up period ranged from 1.3 to 5 years. Herein, we present a review of the literature using this technique.
authors.affiliation: From the *Columbia University Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL USA; and †Columbia University Medical Center, New York, NY USA.
authors.forename: Orlando
authors.initials: O
authors.lastname: Santana
authors.forename: Sandeep
authors.initials: S
authors.lastname: Singla
authors.forename: Christos G
authors.initials: CG
authors.lastname: Mihos
authors.forename: Andrés M
authors.initials: AM
authors.lastname: Pineda
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kurlansky
authors.forename: Isaac
authors.initials: I
authors.lastname: George
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
authors.forename: Nirat
authors.initials: N
authors.lastname: Beohar
mesh_terms: D003131:Combined Modality Therapy; D006331:Heart Diseases / Q000601:surgery*; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome