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Subject Area

Cardiac Surgery

Article Type

Original Study

Abstract

Objectives This study aims to evaluate the clinical outcome of combined coronary artery bypass grafting (CABG) and valve replacement within 6 months regarding safety, efficacy, and feasibility. Patients and methods From 2016 to 2020, 41 patients were operated on with combined CABG with aortic valve (AV) and/or mitral valve (MV) replacement. Patients were classified according to valve type into three groups: AV (n = 20), MV (n = 10), and double valve (DV) (n = 11) groups. Comparative analysis of demographic, preoperative, operative, and postoperative data with follow-up clinical outcome for 6 months was done. Results Preoperatively hypertension and rheumatic valves were significantly frequent in AV and MV groups, respectively, with P value of 0.011. ICU and hospital stays were significantly longer in the DV group. Permanent pacemaker insertion was done in three (27%) patients in the DV group, with a statistically significant difference (P = 0.027). Within the first month, pleural, pericardial effusion, and atrial fibrillation were the most frequent complications (36.6, 29.2, and 29.2%, respectively), followed by sternal wound infection (12.2%), acute kidney injury (7.3%), myocardial infarction (7.3%), postoperative bleeding (4.8%), tamponade (7.3%), agitation and confusion (7.3%), and subdural hemorrhage (7.3%). Mortality rate was two (4.9%) patients. At the sixth month, 12.8% of patients remained atrial fibrillation, readmission was seen in 4.9% for noncardiac causes, and no mortality was reported. Echocardiography data for all 39 survivors revealed increase in mean postoperative left ventricular ejection fraction to 48.3 and 50.4% at 1 and 6 months, respectively, with significant difference at the 6 month (P = 0.004). Overall, New York Heart Association grading showed significant improvement (P < 0.001) at 1 and 6 months. Conclusion Concomitant CABG with valves replacement is relatively safe with acceptable short-term outcomes and complications.

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