Determinants of Operative Survival Following Combined Mitral Valve Replacement and Coronary Revascularization

DiSesa, Verdi J.; Cohn, Lawrence H.; Collins, John J.; Koster, J. Kenneth; Vandevanter, Stephen

doi:10.1016/s0003-4975(10)62992-x

Cited by 78 publications

(14 citation statements)

References 25 publications

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“…Nonoperative strategy carries a mortality of nearly 80% within the first week of rupture . Multiple centers have reported operative mortality with mitral valve repair or replacement ranging between 19% and 53% …”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] Multiple centers have reported operative mortality with mitral valve repair or replacement ranging between 19% and 53%. 5,6 2 | METHODS From 2011 to 2017, 2379 patients underwent mitral valve surgery at the University of Pittsburgh Medical Center. Twenty-four (1.0%) of these patients had a PMR.…”

Section: Introductionmentioning

confidence: 99%

“…However, some patients can present in a delayed fashion. All patients in this cohort were operated on the same day (<12 h) (Figure 4).Concomitant revascularization has been shown in prior studies to have a short-and long-term benefit for survival with concomitant CABG 5,7,8. Chevalier et al reported their experience in 37 patients who had mitral valve surgery for PMR post MI.…”

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confidence: 95%

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Mitral valve surgery for acute papillary muscle rupture

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 95%

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Mitral valve surgery for acute papillary muscle rupture

et al. 2018

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“…Combined valvular heart surgery and CABG had a substantially higher hospital mortality than those having either procedure alone, which ranged from 7% to 18% 2-9. Since there have not been many reports about this issue, we reviewed the clinical results of our 15-year experience of combined valvular heart operations and coronary revascularization to evaluate the clinical results, and to determine if co-existing coronary artery disease affected long-term survival.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Coexisting Coronary Artery and Valvular Heart Disease

2010

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PurposeCombined coronary artery bypass (CAB) and valve surgery is one of the most challenging surgical procedures, but the operative results have improved over the years.Materials and MethodsFrom 1989 through 2004, combined CAB and valve operations were performed in 125 patients. Mean age was 63 years, and 86 patients were male. Forty-six patients were diagnosed with coronary artery disease during preoperative evaluation for valvular heart disease (VHD). All patients underwent CAB, and one or more underwent valve replacement or repair (mitral: 54, aortic: 61, tricuspid: 3, DVR: 7) simultaneously.ResultsMean number of distal graft was 1.98 ± 1.07, and LIMA was used in 68% of patients. Early mortality occurred in 6 patients (4.8%), and the causes were heart failure (4) and sepsis (2). Mean follow-up duration was 91.4 ± 40.9 months (range: 47-245), and late mortality occurred in 4 patients. Kaplan Meier estimated survival rates at 1, 5, and 10 years were 94.4%, 92.3%, and 89.9%, respectively.ConclusionCombined coronary and valve operations can be performed safely with optimal surgical results. Although the surgical mortality of coexisting coronary and VHD is higher than either isolated coronary or valvular operations, it may not affect the long-term survival.

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“…The operative mortality in combined CABG and mitral valve replacement was 23%. 4 After introduction of cardioplegia, the outcome from combined CABG and valve surgery has been improved, although early mortality in mitral valve surgery combined with CABG remained significantly higher.5'6 The rate of operative mortality and perioperative myocardial infarction in combined CABG and aortic valve replacement was 2%5 and 0-4%, 2,3 respectively. The early mortality of combined CABG and mitral valve surgery was also reduced to 4-13%.…”

Section: Discussionmentioning

confidence: 99%