Response to Letter Regarding Article, “Predictors of Long-Term Survival After Coronary Artery Bypass Grafting Surgery: Results From the Society of Thoracic Surgeons Adult Cardiac Surgery Database (the ASCERT Study)”

Abstract

We thank Dr Poullis for his careful review of our article,1 and we are pleased to respond to the issues he has raised. First, our study was confined to patients who underwent isolated coronary artery bypass grafting. However, as in most real-world populations of patients who undergo this procedure, some of those in our study did have mild coexisting valve disease that was not felt to require concomitant repair or replacement. There were even a very few patients with more severe valve disease who, for what were likely to have been unusual circumstances, only had coronary artery bypass grafting. The increased hazard ratios associated with coexisting moderate to severe valvular insufficiency and with progressive aortic stenosis convey an important message that would not have been apparent had we excluded all such patients from our study. The presence of uncorrected, significant coexisting valve disease is associated with an increased risk of long-term …