Aortic Valve Replacement for Severe Aortic Stenosis and Concomitant Coronary Artery Bypass Graft: Assessing the Impact of Grafts Number

Abstract

Background: The impact of multivessel coronary artery bypass grafting on outcomes after combined aortic valve replacement and coronary artery bypass grafting (AVR-CABG) has not been sufficiently evaluated. It is well established that Patients diagnosed with aortic stenosis (AS) indicated for AVR usually also have coronary artery disease (CAD) requiring CABG. The impact of grafts number in case of combined AVR-CABG also has not been sufficiently evaluated. This study aimed to evaluate the impact of grafts number on outcome of concomitant AVR-CABG.

Methods: This prospective study enrolled patients who had operated AVR-CABG between February 2019 till January 2021 in the Cardio-Thoracic Surgery Department of Zagazig University Hospital using the traditional on-pump technique.

Results: The study consisted of 50 AVR-CABG patients. Mean follow-up was 1 years. Preoperative clinical characteristics were well-matched between patients who received one (n 14), two (n 26), or multiple (n 10 ) bypass grafts. Operative mortality was 0%, 3.8 %, and 10 %, respectively. Patients in all groups shows significant improvement in New York Heart Association (NYHA) status (p < 0.01). Renal failure was significantly associated with multiple grafts patients. The number of coronary bypass grafts did not predict mortality.

Conclusions: For patients undergoing AVR-CABG, the number of bypass grafts does not adversely affect survival.