Early results of combined coronary artery by-pass grafting and valve replacement

ABSTRACT

In the era of continously evolving cardiac interventions, the profile of patients referred for coronary artery bypass grafting [CABG] is changing to include older patients with concomitant diseases and co-morbidities. Studies on the results of a specific type of valve pathology operation in combination with CABG are few. This study conducted on 29 consecutive patients who underwent combined CABG and valve operations between January 2002 and December 2006. Follow-up for survival and events continued six months after discharge. All patients underwent cardiac catheterization within 3 months before operation Patients age ranged from 30-72 years, with a mean of 56.3 +/- 9.64 years, of these patients, 21 patients [72.4%] were males, whereas 8 patients [27.6%] were females. They underwent a combination of CABG with either isolated aortic valve replacement [n - 16], isolated mitral valve replacement [n = 9], or double valve replacement [n = 4]. LAD was grafted in 23 patients, RCA was grafted in twelve patients, OM was grafted in ten patients and saphenous vein was used to graft the diagonal branch of the LAD in two patients. It was found that sex, age, the duration of aortic cross clamping, and arrythmias specially atrial fibrillation and heart block are important determinants of early post-operative events suggesting restriction of the number of distal anastomosis to shorten the aortic cross-clamp