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European Journal of Cardio-Thoracic Surgery, Vol 8, 57-62, Copyright © 1994 by European Association for Cardio-thoracic Surgery
SS Ashraf, N Shaukat, N Odom, D Keenan and G Grotte
To study the effect of various perioperative and operative variables, we
analysed the results of 66 consecutive patients undergoing mitral valve
replacement (MVR) and coronary artery bypass grafting (CABG). The mean age
was 61.2 years (34 males and 32 females), the mean follow-up 54.71 +/- 7.8
months. The hospital mortality rate was 7.6% (5/66). New York Heart
Association (NYHA) functional class (P < 0.01), left ventricular global
wall motion score (increased scores indicating impaired function, P =
0.005) and cross-clamp time (P < 0.05) were associated with hospital
mortality. There was no significant relationship of age (certainly up to
the age of 70), cause of mitral valve disease, severity of mitral
regurgitation, number of grafts, presence of angina, or previous myocardial
infarction with hospital mortality. There were eight late deaths, survival
at 1, 3 and 5 years was 92.4%, 83.2% and 80.2%, respectively. Although
there was a trend for pulmonary vascular resistance (P = 0.15), NYHA class
(P = 0.18) and aortic cross-clamp time (P = 0.09) to be associated with
late survival, the only factor significantly related to late survival was
global wall motion score (P = 0.001), i.e. those with scores of more than
10. Severity of mitral regurgitation and cause of mitral valve disease have
been reported as being related to late survival in patients undergoing
combined CABG and MVR, but we have found no such relationship. Our results
indicate that both hospital and late mortality after this operation are
strongly correlated with left ventricular function.
ARTICLES
Early and late results following combined coronary bypass surgery and mitral valve replacement
Department of Cardiothoracic Surgery, Manchester Royal Infirmary, UK.
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