Abstract: Objective To summarize the experience of combined coronary artery bypass grafting(CABG) and valve replacement. Methods From May 1997 to March 2006, the results of 80 consecutive patients undergone valve replacement (MVR) and CABG were analyzed. CABG were performed withtotal grafts in 159 grafts (mean 1.99 grafts), with mitral valve replacement (MVR) in 49 patients, with aortic valve replacement (AVR) in 18 patients, with MVR+AVR in 13 patients(mechanical valve replacement in 68 and biological valve replacement in 12). Results The hospital time after operation was 19.2±13.4d. The hospital mortality rate was 12.5% (10/80). The primary cause of death included low cardiac output yndrome, acute renal failure, nervous system complications ,ventricular fibrillation and cardiac arrest. Multivariate testing of preoperative and operative description identified that preoperative myocardial infarction, worse cardiac function, radiographic cardiac enlargement and low ejection fraction were associated with an increase of hospital mortality (P＜0.05). There were postoperative complications including bleeding, severe ventricular arrhythmia, nervous system complications and incision infection. Followup of 58 patients (82.86%, range 6 to 60 months) showed the symptoms of angina pectoris and heart failure were significantly relieved. There were 2 longterm deaths (cerebral infarction and lung infection). Conclusion Combined CABG and valve replacement is an effective way for treatment of coronary artery and valvular heart disease. Improving the heart function preoperatively, strengthening myocardial protection, shortening operation and myocardial ischemia time, and complete revascularization are the key factors for success operation.
Citation： DUAN Liang,XIAO Mingdi,YUAN Zhongxiang,YANG Dicheng,HU Zhenlei,WANG Limin.. Combined Coronary Artery Bypass Grafting and Valve Replacement: Report of 80 Cases. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(3): 169-172. doi: Copy