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