Aortic Valve Replacement for Aortic Stenosis and Concomitant Coronary Artery Bypass: Long-term Outcomes and Predictors of Mortality

Cho, Won Chul; Yoo, Dong-Gon; Kim, Joon Bum; Lee, Jaewon; Choo, Suk-Jung; Jung, Sung‐Ho; Chung, Cheol Hyun

doi:10.5090/kjtcs.2011.44.2.131

Cited by 3 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Formica et al [21] the study revealed that the iAVR group exhibited higher EF% (56.7% vs. 54%, respectively; p = 0.028) and higher aortic peak gradients relative to combined procedures, but showed no differences in m. AVA between the two groups. Furthermore, previous studies indicated that a low EF increased the risk of undergoing AVR-CABG [1,8,22] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Concurrent Aortic Valve Replacement and Coronary Artery Bypass Grafting: Early Outcome and Predictors of Mortality

Elfakharany¹,

Kotb²,

Azab³

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: The most prevalent structural heart valve condition that affects the aging population is degenerative aortic stenosis (AS). Conflicting reports have been reported on the effect of concomitant coronary artery bypass grafting (CABG) and aortic valve replacement (AVR) in patients with AS. Objective: At our medical center, we aimed to investigate outcomes of patients that occurred following AVR for AS conditions with and without CABG. Patients and Methods: A prospective study was performed in the Cardiothoracic Surgery Department from February 2019 to January 2021. A total of 50 patients were enrolled in the study and were equally divided into two groups. Group A involved patients who had an isolated AVR (n = 25). At the same time, Group B included patients who underwent AVR in conjunction with CABG (n = 25). AVR and all bypass anastomoses were performed under intermittent antegrade cold blood cardioplegia. Furthermore, we compared demographic, preoperative, operative, and postoperative data within groups. Results: Our finding revealed that the combination surgery patients were significantly older than the AVR patients (63.4 ± 8.7 vs. 57.7 ± 6.9 years; p = 0.014). The hospital mortality rate was similar in the combined procedure and AVR. The aortic cross-clamp time and cardiopulmonary bypass time were significantly longer in AVR + CABG compared to AVR patients (p < 0.0001). One-year postoperative improvements were reported in the NYHA class, with only one hospital mortality case among the two groups. Conclusions: We concluded that with optimal myocardial protection, minimal cross-clamp, and cardiopulmonary bypass time, in addition to the ideal and precise technique, the combined result of CABG-AVR was comparable to that of isolated CABG or AVR.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Aortic stenosis and coronary atherosclerosis may cause myocardial ischemia and its consequences, including angina, myocardial infarction, and mortality independently [1] .…”

Section: Introductionmentioning

confidence: 99%

Concurrent Aortic Valve Replacement and Coronary Artery Bypass Grafting: Early Outcome and Predictors of Mortality

Elfakharany¹,

Kotb²,

Azab³

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…In order to improve the mortality rates of hospitals that have a low number of heart surgeries, consideration is needed for the diverse situations of each hospitals and analysis regarding the particular high mortality rates. For heart surgeries, the clinical conditions of the patients, such as comorbidity and emergency surgeries, have a significant impact in the treatment outcomes [12,13]. …”

Section: Discussionmentioning

confidence: 99%

The Association Between Treatment Frequency and Treatment Outcome for Cardiovascular Surgeries

Choi

Park

Kim

et al. 2016

Korean J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

BackgroundThis study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years.MethodsHospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed.ResultsThe chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually.ConclusionThese results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.

show abstract

Predictors of Operative Mortality in Cardiac Surgical Patients with Prolonged Intensive Care Unit Duration

LaPar

Gillen

Crosby

et al. 2013

Journal of the American College of Surgeons

View full text Add to dashboard Cite

Background Several systems have been developed to predict mortality following intensive care unit (ICU) admission in medical and surgical patients. However, a similar tool specific to cardiac surgical patients with prolonged intensive care unit duration does not exist. The purpose of the present study was to identify independent perioperative predictors of operative mortality among cardiac surgical patients with prolonged ICU duration. Study Design From 2003-2008, 13,105 cardiac surgical patients with ICU durations greater than 48 hours were identified within a statewide database. Perioperative factors, including Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM), were evaluated. Univariate and multivariate analyses identified significant correlates of operative mortality and their relative strength of association as determined by the Wald χ2 statistic. Results Mean patient age was 66.8±11.2 years, median ICU duration was 76.5 [56.0-124.0] hours, and mean STS PROM was 4.4%±6.2%. Among preoperative and operative factors, intra-aortic balloon pump use, patient age, immunosuppressive therapy, hemodialysis requirement, cardiopulmonary bypass time, and heart failure proved to be the strongest correlates of mortality (all p<0.05) on risk-adjusted multivariate analysis. Interestingly, type of cardiac procedure had no significant association with mortality after risk adjustment. Among postoperative complications, cardiac arrest, prolonged mechanical ventilation (>24 hours) and stroke were the strongest predictors of risk-adjusted mortality (all p<0.001). Conclusions Operative mortality may be predicted by select risk factors for cardiac surgical patients with prolonged intensive care unit duration. Patient age, preoperative intra-aortic balloon pump, and postoperative cardiac arrest, prolonged ventilation and stroke have the strongest association with mortality. Identification of these factors in the perioperative setting may enhance resource utilization and improve mortality following cardiac surgery.

show abstract

Aortic Valve Replacement for Aortic Stenosis and Concomitant Coronary Artery Bypass: Long-term Outcomes and Predictors of Mortality

Cited by 3 publications

References 25 publications

Concurrent Aortic Valve Replacement and Coronary Artery Bypass Grafting: Early Outcome and Predictors of Mortality

Concurrent Aortic Valve Replacement and Coronary Artery Bypass Grafting: Early Outcome and Predictors of Mortality

The Association Between Treatment Frequency and Treatment Outcome for Cardiovascular Surgeries

Predictors of Operative Mortality in Cardiac Surgical Patients with Prolonged Intensive Care Unit Duration

Contact Info

Product

Resources

About