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

Abstract

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.