Therapeutic effect of simultaneous CABG and HVR on CHD patients with heart valve disease and its in-fluence on prognosis / 心血管康复医学杂志

ABSTRACT

Objective:To explore influence of simultaneous coronary artery bypass grafting (CABG) and heart valve replacement (HVR) therapy on ICU stay time,cardiac function and long-term prognosis in patients with coronary heart disease (CHD) complicated heart valve disease (HVD).Methods:A total of 94 CHD + HVD patients were selected from our hospital.They were randomly and equally divided into non-simultaneous treatment group (NST group) and simultaneous treatment group (ST group),according received CABG and HVR simultaneously.Postop-erative cardiac function,related indexes during and after operation,survival rate within five years and incidence rate of adverse reactions were compared between two groups.Results:Compared with NST group after operation,there were significant rise in LVEF [ (44.23 ± 11.03)% vs.(49.58 ± 11.39)%],left ventricular early diastolic peak flow velocity/late diastolic peak flow velocity (E/A) [ (0.87 ± 0.09) vs.(0.94 ± 0.12)] and percentage of NYHA classⅡ(46.81% vs.70.21%),and significant reductions in left atrial diameter (LAD) [ (39.47 ± 10.16) mm vs.(34.46 ± 8.72) mm],left ventricular end-diastolic dimension (LVEDd) [ (58.49 ± 10.65) mm vs.(53.17 ± 9.13) mm],left ventricular end-systolic dimension (LVESd) [ (48.69 ± 8.73) mm vs.(42.07 ± 8.36) mm],cardiotho-racic ratio (CTR) [ (0.66 ± 0.14) vs.(0.54 ± 0.09)],percentage of NYHA class Ⅲ(34.04% vs.12.77%),as-cending aorta block time,extracorporeal circulation time,ventilator assist time,ICU stay and hospitalization time in ST group,P＜0.05 or ＜0.01.Compared with NST group after five-year follow-up,there was significant reduction in incidence rate of major adverse cardiovascular events (40.43% vs.19.15%),and significant rise in five-year sur-vival rate (44.68% vs.68.08%) in ST group,P＜0.05 both.Conclusion:Simultaneous CABG and HVR can signifi-cantly shorten ICU stay time etc.postoperative observation index,improve cardiac function and long-term survival rate,reduce incidence rate of adverse reactions in CHD + HVD patients.