Combined operation for coronary artery bypass grafting and mitral valve replacement; risk and outcome

Q. Mustafa, Mohammed (2021) Combined operation for coronary artery bypass grafting and mitral valve replacement; risk and outcome. International Journal of Surgery Open, 35.

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Abstract

Introduction The combination of mitral valve replacement (MVR) with coronary artery bypass grafting (CABG) is generally thought to have a greater early and late mortality than either procedure alone. The aim of this study is to review single center experience for the concomitant MVR and CABG. Patients and methods This is a single center, retrospective, single cohort study, composes of consecutive cases. It included all the cases of combined operation of MVR and CABG. The patients were followed up for a median duration of two years (six months to four years). The data were collected from hospital records and registers of hospital statistics. The followings were obtained; socio-demographic data, information regarding clinical courses, intraoperative findings, and post-operative follow up data. Result The study included 72 cases, the mean age was 56 years, 38 of them (53%) were males and 34 (47%) were female. The most common comorbidity was hypertension which was found in 24 patients (33%). The mean preoperative ejection fraction was 59%. Twenty-two patients (30.6%) had single graft, 21 patients (29.2%) underwent 3-vessel grafting, 16 patients (22.2%) had 2-vessel grafting, and 13 cases (18.1%) underwent 4-vessel grafting. The CPB duration ranged from 108 to 280 min with a mean of 182 min and cross-clamp time ranged from 80 to 186 min with a mean of 122 min. The most common complication was plural effusion which occurred in 8 cases (11.1%) and managed by aspiration. Overall mortality was 8.3% (4 patients). Conclusion CABG and chordal-sparing and posterior leaflet replacement has favorable outcome, as well as minimizes the need of redo surgery as in repair.one of the best options for CAD and sever MR.

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