[The surgical experiences and risk factors of combined valvular procedure and myocardial revascularization].

OBJECTIVE

To introduce the experience of combined valve procedure and CABG.

METHODS

61 men and 15 women, with a mean age of 56 years, underwent combined valve procedure and CABG. CABG was performed with AVR (1 - 3 grafts) in 25 patients, with MVR (1 - 4 grafts) in 31 (MVR + AVP in 2, MVR + TVP in 3), with aortic and mitral valve replacement (1 - 3 grafts) in 18 (BVR + TVP in 2), with MVP (1 graft) in 1 and with MVP + TVP (1 graft) in 1 patient. Rheumatic disease was present in 67 and degenerative aortic and mitral valve disease was present in 9. SPSS statistical software was used to analyse the risk factors of the operation.

RESULTS

6 operative deaths (7.89%) occurred. 63 patients (63/70) who survived the operation were followed up for a mean period of 26.8 months. The function of heart in 62 patients was significantly improved. One patient died of SBE 9 months after operation.

CONCLUSION

The combination of valve replacement or repair with coronary revascularization generally increases operative mortality. The hospital mortality is related to preoperative myocardial infarction, NYHA class IV, lower EF and the longer time of CPB and clamping aorta. Grafting in all significant coronary lesions, restoration of valvular function and good myocardial protection are the key factors for the success of CABG with valvular procedure.