Risk Factor Analysis for the Prognosis in Elder Patients With Combined Aortic Valve Replacement and Coronary Artery Bypass Grafting
10.3969/j.issn.1000-3614.2015.12.004
- VernacularTitle:老龄主动脉瓣置换联合冠状动脉旁路移植术患者预后危险因素分析
- Author:
Zhengbiao ZHA
;
Tao YANG
;
Hansong SUN
;
Yunhu SONG
;
Wei WANG
;
Jianping XU
- Publication Type:Journal Article
- Keywords:
Heart valve prosthesis implantation;
cardiopulmonary bypass;
Aged;
Prognosis
- From:
Chinese Circulation Journal
2015;(12):1147-1151
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: To analyze clinical characteristics with the early and late prognosis in elder patients with combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG).
Methods: A total of 232 patients≥65 years of age who received AVR-CABG in our hospital from 2004-02 to 2014-09 were retrospectively analyzed. The risk factors affecting the early and late prognosis in those patients were studied by multivariate Logistic regression analysis and Cox proportional hazards model.
Results: The in-hospital death happened in 7/232 (3.0%) patients, early post-operative complication with prolonged mechanical ventilation time was 28 (12.1%) and bleeding was 14 (6.0%). The follow-up study was conducted in 225/232 (97.0%) survived patients from 3 months to 10 years at the mean of (41.2 ± 29.0) months; 6 (2.7%) patients had cardiac death, the major late post-operative adverse events were cardiac dysfunction (III to IV) or recurrence of angina (8.9%). Multivariate Logistic regression analysis revealed that female (P=0.019, OR=2.576), pre-operative atrial ifbrillation (AF) (P=0.012, OR=3.541) and CPB time (P=0.000, OR=3.781) were the independent risk factors affecting early post-operative outcome. Cox proportional hazards model presented that hyperlipidemia (P=0.025, HR=2.535), smoking (P=0.009, HR=3.414) and the history of PCI (P=0.013, HR=3.562) were the independent risk factors inlfuencing late prognosis of AVR-CABG.
Conclusion: The overall effect of AVR-CABG in elder patients was satisfactory. Female, pre-operative AF, CPB time may affect the early post-operative outcome, while hyperlipidemia, smoking and PCI history could inlfuence the long-term prognosis in relevant patients.
