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. doi: 10.1111/jocs.12365 (J Card Surg 2014;29:450-454) © 2014 Wiley Periodicals, Inc.

First-time, isolated surgical aortic valve replacement after prior coronary artery bypass surgery: Results from the RECORD multicenter registry

BEGHI, CESARE;
2014-01-01

Abstract

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. doi: 10.1111/jocs.12365 (J Card Surg 2014;29:450-454) © 2014 Wiley Periodicals, Inc.
2014
www.blackwellpublishing.com/journal.asp?ref=0886-0440
Aged; Aged, 80 and over; Aortic Valve; Constriction; Female; Heart Arrest, Induced; Humans; Hypothermia, Induced; Male; Mammary Arteries; Middle Aged; Sternotomy; Survival Rate; Time Factors; Treatment Outcome; Coronary Artery Bypass; Heart Valve Prosthesis Implantation; Registries; Cardiology and Cardiovascular Medicine; Surgery; Medicine (all)
Biancari, Fausto; Onorati, Francesco; Mariscalco, Giovanni; De Feo, Marisa; Messina, Antonio; Santarpino, Giuseppe; Santini, Francesco; Beghi, Cesare; Ratta, Ester Della; Troise, Giovanni; Fischlein, Theodor; Passerone, Giancarlo; Juvonen, Tatu; Mazzucco, Alessandro; Heikkinen, Jouni; Faggian, Giuseppe
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2053821
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