Immediate results of combined coronary bypass surgery and aortic valve replacement with incomplete and complete myocardial revascularization

Abstract

Introduction . Coronary heart disease and aortic valve stenosis still occupy a leading position among cardiovascular diseases. Against the background of an increase in life expectancy, patients with a combined pathology of the heart are increasingly appearing. Without surgical treatment, such patients have an unfavorable prognosis of life with a high mortality rate. Simultaneous surgical correction of coronary heart disease and aortic valve stenosis is a treatment method that can improve the prognosis and prolong the life of a patient. At the same time, combined interventions remain higher-risk operations compared to isolated aortic valve replacement and isolated coronary artery bypass grafting. The Objective was to evaluate the effect of incomplete and complete myocardial revascularization on the immediate results of surgical correction of combined pathology of the aortic valve and coronary arteries. Methods and Materials . For the period from 2017 until June 2022, 62 aortic valve replacement operations in combination with coronary artery bypass grafting were performed in the cardiac surgery department of the Leningrad Regional Clinical Hospital. The operated patients were divided into two groups. The group 1 included (n=32) patients who underwent aortic valve replacement and complete myocardial revascularization. The group 2 included patients (n=30) who underwent aortic valve replacement and incomplete myocardial revascularization. Results . Postoperative periods in both groups, according to the structure of early postoperative complications, are generally similar. The mortality rate in both groups did not exceed the predicted mortality rate and corresponded to the data of various literary sources. Conclusion . Our observation data showed that the mortality rate in the early postoperative period, in combined operations, does not depend on the completeness of revascularization in combined operations of coronary artery bypass grafting and aortic valve replacement. It is necessary to perform as complete myocardial revascularization in combined operations as technically feasible and appropriate in a clinical situation.