الفهرس Only 14 pages are availabe for public view
 |  | from | 128 |  |  |
| | | from | 128 | | |
Abstract
Background: The combination of valve and coronary artery
disease(CAD) is a challenging pathology for surgical treatment. In recent
years an increasing number of patients suffering from such coexisting
pathologies have been offered cardiac surgery, mainly because of the
aging of the population of coronary artery bypass grafting (CABG)
candidates. Patients and methods: 30 patients subjected to concomitant
surgery for their valvular and ischemic heart disease were included in the
study. We documented their preoperative variables, the surgical technique
followed, and the postoperative course during the ICU and ward stay,
with associated mortality and morbidity. Results: The study included 19
males with a mean age of 44.2± 5 years (range 40 to77) and 11 females
with a mean age of 46±5 years (range 42 to 72). For patients with IHD
and isolated mitral valve disease, 12 patients had CABG + MVR; while 5
had CABG + MV repair. For those with IHD and isolated aortic valve
disease, all the 10 patients had CABG + AVR. Concerning the 3 patients
with IHD and both mitral and aortic valve pathologies, 2 of them had
CABG + AVR + MV repair, while only 1 patient had CABG + double
valve replacement (DVR). The total number of distal anastomoses was
58, 21 of them was LIMA to the LAD, while a SVG was used to bypass a
critical stenosis in the LAD only 3 patients. A SVG was used to bypass a
critical anastomosis in coronaries other than the LAD in 34 occasions. 37
proximal anastomoses were done, all in the form of an aorto- SVG
anastomosis. Conclusion: combined V/CABG surgery carries a greater
risk than surgery for either pathology alone. Risk increases with female
sex and advanced age. Surgery for CABG and IMR carries the greatest
risk.
Key words: combined – coronary – valve – surgery