Yonsei Med J.  2010 May;51(3):326-331. 10.3349/ymj.2010.51.3.326.

Surgical Management of Coexisting Coronary Artery and Valvular Heart Disease

• Lee S
• Chang BC
• Yoo KJ

• KMID: 1074982
• DOI: http://doi.org/10.3349/ymj.2010.51.3.326

Abstract

PURPOSE
Combined 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 METHODS
From 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.
RESULTS
Mean 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.
CONCLUSION
Combined 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.

Keyword

Coronary artery disease; coronary artery bypass; valvular diseases

MeSH Terms

Adult
Age Factors
Aged
Coronary Artery Bypass/*methods
Coronary Artery Disease/mortality/*surgery
Coronary Vessels/pathology/surgery
Female
Heart Valve Diseases/mortality/*surgery
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Sex Factors
Treatment Outcome

Figure

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  Fig. 1 Age distribution of coronary artery disease in male patients.

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  Fig. 2 Age distribution of coronary artery disease in female patients.

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