Surgical management of coronary artery disease associated with valvular heart disease
- VernacularTitle:冠心病合并心脏瓣膜疾病的手术治疗
- Author:
Shengli JIANG
;
Changqing GAO
;
Bojun LI
- Publication Type:Journal Article
- Keywords:
coronary disease;
heart valve diseases;
cardiac surgical procedures
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the experience of surgical management of coronary artery disease associated with valvular heart disease. Methods From 1998 to 2004, fifty-seven patients with coronary artery lesion and valvular disease underwent coronary artery bypass grafting with concomitant valvular operation. The mean age of the patients was 60 years. Heart function (NYHA) was class II in 9 patients, class III in 37, class IV in 11. 37 patients had mitral valve lesion, 11 aortic valve lesion, and 9 with lesions of both valves. 26 cases had single-vessel disease, 20 with double-vessel disease,11 with triple-vessel disease, and 9 with main artery lesion. After cardiac arrest with the aid of cold cardioplegia under moderate cardiopulmonary bypass, distal anastomosis of the saphenous vein (SV) to the target vessels was first performed followed by valve replacement (49 patients) or valvular plasty (8 patients). The left mammary artery was grafted to the left anterior descending artery before aortic declamping. Proximal anastomosis of the SV to the aorta was finally finished on beating heart. The mean bypass time was 173.5 min and the mean duration of aortic cross-clamping was 112.6 min. Results Except one patient, no mortality and severe morbidity occurred during hospitalization. Heart function was improved to class I-II and no one died during follow-up period. Conclusion CABG combined with valve surgery can be safely performed with good results.
