Document Detail


Should the aortic valve be replaced in patients with mild aortic stenosis admitted for coronary surgery?
MedLine Citation:
PMID:  19012211     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The question whether the aortic valve in patients with mild aortic stenosis undergoing coronary artery bypass grafting (CABG) should be replaced or left alone is still controversial. METHODS: Between 01/1995 and 03/2004, 38 patients (30 male, 8 female, mean age 70.9 +/- 7.8 years) required redo AVR 7.1 +/- 4.8 years after primary CABG, while 202 patients (125 male, 77 female, mean age 72.7 +/- 7.8 years) underwent combined AVR and CABG (1.9 +/- 0.8 grafts/patient). To evaluate the different approaches, the data of the redo-AVR group were compared with the data of a propensity-score matched group of AVR + CABG patients. RESULTS: All patients survived the procedure; the 30-day survival was 94.7 % in both groups. The 1- and 5-year survival rates were 94.7 % and 83.8 % in the AVR after CABG group, and 94.7 % and 86.9 % in the AVR + CABG group, respectively. The late mortality was 28.9 % in the AVR after CABG and 25 % in the AVR + CABG group. Statistically, significant differences regarding perioperative mortality and morbidity could not be detected, neither with nor without propensity score analysis. CONCLUSION: Combined AVR and CABG in patients with coronary artery disease and mild to moderate aortic stenosis seems advisable in an institution with an equally low perioperative risk for both procedures, because the patient will need only one surgical procedure instead of undergoing surgery with all the associated risks twice.
Authors:
A Böning; S Bürger; S Fraund; T Attmann; J T Cremer; J Hedderich; G Lutter
Publication Detail:
Type:  Journal Article     Date:  2008-11-14
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  56     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  467-70     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany. andreas.boening@chiru.med.uni-giessen.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve / surgery*
Aortic Valve Stenosis / complications,  surgery*
Coronary Artery Bypass* / mortality
Coronary Disease / surgery
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation / mortality
Humans
Male
Reoperation
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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