Myocardial revascularization combined with aortic valve replacement.

We reviewed 50 consecutive patients who had undergone complete myocardial revascularization combined with aortic valve replacement during a 5-year interval ending in June 1983. A cold blood cardioplegia technique, utilizing not only the native circulation but also the vein conduits, was used. All patients had greater than 70% stenoses of the major coronary arterial system. No patient had valve replacement alone, and no patient was refused operation. The mean number of arteries grafted was 2.3. There were two hospital deaths. One patient had evidence of perioperative myocardial infarction. There were two late deaths and one non-fatal myocardial infarction during the follow-up period, which averaged 16 months. The technique of hypothermic blood cardioplegia used provides a uniform distribution for myocardial protection, especially in the hypertrophied ventricle, and is superior to previously employed methods. This study indicates that myocardial revascularization combined with aortic valve replacement should be performed in patients with coexisting aortic valvular and coronary disease.