BACKGROUND: This multicenter study was undertaken to determine the immediate and long-term outcomes in patients undergoing a primary surgical aortic valve replacement (AVR) who had a previous coronary artery bypass graft surgery with patent grafts. METHODS: One hundred and thirteen consecutive patients (mean EuroSCORE II, 10.3 ± 7.7%, median 8.0%) who underwent first-time isolated AVR after coronary artery bypass grafting (CABG) were the subjects of this multicenter study. The procedure was performed through a full sternotomy in 95.7% of cases, a patent internal mammary artery graft was clamped in 76.6% of patients. The temperature of cardioplegia was ≤12 °C in 62.8% of patients and systemic temperature was <32 °C in 23.9% of patients. RESULTS: Thirty-day mortality was 4.4%. Stroke was observed in 8.0% of patients, low cardiac output syndrome in 14.1%, prolonged tracheal intubation in 20.8%, and intensive care unit stay was longer than five days in 19.5% of patients. Among patients with a patent internal mammary graft (91 patients), clamping of this graft (5.7% vs. 0%, p = 0.57) was associated with a nonsignificant trend toward increased 30-day mortality. One-, three- and five-year survival rates were 91.5%, 90.4%, and 88.4%, respectively. CONCLUSIONS: Patients undergoing isolated AVR after prior CABG have a good immediate and late survival. A history of prior CABG should not be considered an absolute indication for transcatheter AVR.
BACKGROUND: This multicenter study was undertaken to determine the immediate and long-term outcomes in patients undergoing a primary surgical aortic valve replacement (AVR) who had a previous coronary artery bypass graft surgery with patent grafts. METHODS: One hundred and thirteen consecutive patients (mean EuroSCORE II, 10.3 ± 7.7%, median 8.0%) who underwent first-time isolated AVR after coronary artery bypass grafting (CABG) were the subjects of this multicenter study. The procedure was performed through a full sternotomy in 95.7% of cases, a patent internal mammary artery graft was clamped in 76.6% of patients. The temperature of cardioplegia was ≤12 °C in 62.8% of patients and systemic temperature was <32 °C in 23.9% of patients. RESULTS: Thirty-day mortality was 4.4%. Stroke was observed in 8.0% of patients, low cardiac output syndrome in 14.1%, prolonged tracheal intubation in 20.8%, and intensive care unit stay was longer than five days in 19.5% of patients. Among patients with a patent internal mammary graft (91 patients), clamping of this graft (5.7% vs. 0%, p = 0.57) was associated with a nonsignificant trend toward increased 30-day mortality. One-, three- and five-year survival rates were 91.5%, 90.4%, and 88.4%, respectively. CONCLUSIONS:Patients undergoing isolated AVR after prior CABG have a good immediate and late survival. A history of prior CABG should not be considered an absolute indication for transcatheter AVR.
Authors: Francesco Onorati; Augusto D'Onofrio; Fausto Biancari; Stefano Salizzoni; Marisa De Feo; Marco Agrifoglio; Giovanni Mariscalco; Vincenzo Lucchetti; Antonio Messina; Francesco Musumeci; Giuseppe Santarpino; Giampiero Esposito; Francesco Santini; Paolo Magagna; Cesare Beghi; Marco Aiello; Ester Dalla Ratta; Carlo Savini; Giovanni Troise; Mauro Cassese; Theodor Fischlein; Mattia Glauber; Giancarlo Passerone; Giuseppe Punta; Tatu Juvonen; Ottavio Alfieri; Davide Gabbieri; Domenico Mangino; Andrea Agostinelli; Ugolino Livi; Omar Di Gregorio; Alessandro Minati; Mauro Rinaldi; Gino Gerosa; Giuseppe Faggian Journal: Interact Cardiovasc Thorac Surg Date: 2016-03-14
Authors: Michael J Reardon; Robin H Heijmen; Nicolas M Van Mieghem; Mathew R Williams; Steven J Yakubov; Daniel Watson; Neal S Kleiman; John Conte; Atul Chawla; David Hockmuth; George Petrossian; Newell Robinson; A Pieter Kappetein; Shuzhen Li; Jeffrey J Popma Journal: JAMA Cardiol Date: 2019-08-01 Impact factor: 14.676
Authors: Sharaf-Eldin Shehada; Yacine Elhmidi; Öznur Öztürk; Markus Kasel; Antonio H Frangieh; Fanar Mourad; Jaroslav Benedik; Jaafar El Bahi; Mohamed El Gabry; Matthias Thielmann; Heinz Jakob; Daniel Wendt Journal: Cardiol Res Pract Date: 2018-04-05 Impact factor: 1.866