It has been reported that the short-term mortality of concomitant aortic and mitral valve replacement (AVR and MVR) is considerable and concomitant
coronary artery bypass graft (CABG) has adverse effects on the survival of patients with valve replacement surgery. We summarize the short- and mid-term outcome after concomitant CABG, AVR and MVR in our centre.
METHODS: Between 2003 and 2013, 103 patients (68 males, 35 females, age: 60.1 ± 10.1 years) underwent CABG, AVR and MVR for
rheumatic heart disease (RHD) and
coronary artery disease (CAD). The median follow-up was 47.6 months. Most of the patients were asymptomatic at rest. We analysed demographic, clinical and operative data of patients to define independent predictors of overall survival,
cardiac event-free survival as well as
cardiac death.
RESULTS: The rate of 30-day survival was 93% (n = 96). The corresponding rates of overall survival and
cardiac event-free survival and the cumulative incidence rate of
cardiac death at 1 year were 80.2, 77.3 and 10.9%; the same at 4 years were 73.7, 64.6 and 15.8%. The corresponding freedom rates from anticoagulation-associated major haemorrhage; a composite of major
bleeding events, thromboemboli and valvular
thrombosis; cardiac
rehospitalization; major adverse valve-associated events; and significant malfunction of the prosthetic valve were 96.2, 95.3, 94.7, 81.6 and 97.7% at 1 year. The corresponding freedom rates from anticoagulation-associated major haemorrhage; a composite of major
bleeding events, thromboemboli and valvular
thrombosis; cardiac
rehospitalization; major adverse valve-associated events; and significant malfunction of the prosthetic valve were 93.5, 91.0, 91.4, 73.5 and 95.5% at 4 years. The independent predictors of overall survival were age, cigarette smoking,
chronic kidney diseases and balloon pump insertion. The independent predictors of
cardiac event-free survival were age and previous
myocardial infarction, while age, cigarette smoking, history of
cerebrovascular accident and balloon pump insertion were the independent predictors of
cardiac death.
CONCLUSIONS: