Reports differ regarding the effect of concomitant coronary artery bypass grafting
(CABG) in patients who undergo aortic valve replacement (AVR) for aortic stenosis
(AS), and no reports have described the effect of aortic valve structure in patients
who undergo AVR for AS. A total of 871 patients aged 24 to 94 years (mean 70) whose
AVR for AS was their first cardiac operation, with or without first concomitant CABG,
were included. Patients who underwent mitral valve procedures were excluded. In comparison
with the 443 patients (51%) who did not undergo CABG, the 428 (49%) who underwent
concomitant CABG were significantly older, were more often male, had lower transvalvular
peak systolic pressure gradients and larger valve areas, had lower frequencies of
congenitally malformed aortic valves, had lighter valves by weight, had higher frequencies
of systemic hypertension, and had longer stays in the hospital after AVR. Early and
late (to 10 years) mortality were similar by propensity-adjusted analysis in patients
who did and did not undergo concomitant CABG. Congenitally unicuspid or bicuspid valves
occurred in approximately 90% of those aged 21 to 50, in nearly 70% in those aged
51 to 70 years, and in just over 30% in those aged 71 to 95 years. Unadjusted and
adjusted survival was significantly higher in patients with unicuspid or bicuspid
valves compared to those with tricuspid valves. In conclusion, although concomitant
CABG had no effect on the adjusted probability of survival, the type of aortic valve
(unicuspid or bicuspid vs tricuspid) significantly affected the unadjusted and adjusted
probability of survival.
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Article info
Publication history
Published online: March 05, 2012
Accepted:
December 8,
2011
Received in revised form:
December 8,
2011
Received:
December 5,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
