AORTIC-VALVE REPLACEMENT WITH CORONARY-BYPASS GRAFTING - SIGNIFICANT DETERMINANTS OF 10-YEAR SURVIVAL

  • 1 January 1983
    • journal article
    • research article
    • Vol. 85  (5) , 705-711
Abstract
Concomitant aortic valve replacement (AVR) and myocardial revacularization were performed on 197 patients between 1969-1981. Operative mortality during the period 1969-1975 was 15.6% compared to 5.0% for the years 1976-1981 (P < 0.02). The incidence of perioperative myocardial infarction (PMI) declined over the same period from 14.2 to 2.0% (P < 0.01). Functional class and left ventricular end-diastolic pressure significantly influenced mortality; age, sex, duration of symptoms, cardiac index, wall motion abnormality, type of valve lesion and completeness of revascularization did not. Type of myocardial preservation did not significantly affect operative mortality, although a trend favoring either cardioplegia or continuous perfusion of both coronary ostia and grafts was observed. Life-table analysis shows a survival rate during the 10 yr follow-up period equal to that of patients undergoing isolated AVR. Coronary bypass grafting (CABG) returns patients with combined aortic valve (AVD) and coronary artery disease (CAD) to a prognostic curve determined by their valvular disease alone.