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You are here: Contents > 2013 > Volume 22 Number 2 March > AORTIC VALVE DISEASE > Impact of Concomitant Coronary Artery Bypass Grafting on In-Hospital Outcome in Octogenarians Undergoing Aortic Valve Replacement

Impact of Concomitant Coronary Artery Bypass Grafting on In-Hospital Outcome in Octogenarians Undergoing Aortic Valve Replacement

Shahzad G. Raja, Manoraj Navaratnarajah, Mubassher Husain, Christopher P. Walker, Charles D. Ilsley, Toufan T. Bahrami, Julien A. Gaer, Mohamed Amrani

Departments of Cardiac Surgery, Anaesthesia & Intensive Care, and Cardiology, Harefield Hospital, London, United Kingdom

Background and aim of the study: Abundant data are available reporting excellent in-hospital outcomes after surgical aortic valve replacement (AVR) in octogenarians. However, there is a paucity of studies reporting the in-hospital outcome of concomitant AVR and coronary artery bypass grafting (CABG) in this group of patients. Hence, a comparison was made of the impact of concomitant AVR and CABG versus isolated AVR on in-hospital outcome in octogenarians.

Methods: Between January 2001 and October 2011, a total of 114 consecutive octogenarians undergoing combined AVR and CABG were compared with a control group of octogenarians (n = 68) undergoing isolated AVR. A retrospective analysis was performed of a prospectively collected cardiac surgery database. In addition, the medical notes and charts of all study patients were reviewed.

Results: The two groups had a similar mean age (AVR 82.3 ± 2.4 years versus AVR + CABG 82.6 ± 2.1 years; p = 0.91), demographics and EuroSCORE (AVR 11.4 versus AVR + CABG 13.2; p = 0.12). The aortic cross-clamp and cardiopulmonary bypass times were longer for AVR + CABG patients (p <0.001). In-hospital mortality (7.4% after isolated AVR, 9.6% after AVR + CABG; p = 0.35 between groups) and major clinical outcomes for the two groups were found to be similar except for an increased need for hemofiltration in AVR + CABG patients (p = 0.02).

Conclusion: In-hospital outcomes for concomitant AVR and CABG in octogenarians are comparable to those of isolated AVR, justifying the performance of combined AVR and CABG in this high-risk group of carefully selected patients.


The Journal of Heart Valve Disease 2013;22:177-183

Impact of Concomitant Coronary Artery Bypass Grafting on In-Hospital Outcome in Octogenarians Undergoing Aortic Valve Replacement

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