Outcome of combined coronary artery bypass grafting and aortic valve replacement; a case series

Abstract

IntroductionCo-presentation with both coronary and valve diseases is increasing as the age of the individuals referred for coronary artery intervention rises. The study aims to report a single center experience in combined coronary artery bypass grafting and aortic valve replacement (CABG-AVR). MethodsThis is a retrospective study from January 2014 till January 2019 in a single center. Inclusion criteria included those patients that underwent combined coronary and aortic valve procedure in a single operation. The data were collected from the hospital registry. All patients underwent preoperative coronary angiography, transthoracic echocardiography (TTE), Doppler study was performed for those patients with previous stroke and peripheral vascular diseases. The cases were followed up for a mean duration of 2 years. ResultThe study included 62 patients, 38 of them were males, the mean age was 57 years. Prosthetic mechanical valves were inserted in all of the cases, left internal mammary artery (LIMA) was harvested in all the cases, 24 patients (38.7%) had single graft, 26 cases (41.9%) two grafts, and 12 (19.3) had three grafts. The mean cross clamp time was 148.9 min and mean cardiopulmonary bypass (CPB) time was 187 min. The overall mortality rate was 6.4% (4 patients). ConclusionWith maximum myocardial protection and minimum cross clamp and CPB time and meticulous technique, the outcome of combined CABG-AVR is comparable with isolated CABG or isolated AVR.