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First‐Time, Isolated Surgical Aortic Valve Replacement After Prior Coronary Artery Bypass Surgery: Results from the RECORD Multicenter Registry
Author(s) -
Biancari Fausto,
Onorati Francesco,
Mariscalco Giovanni,
De Feo Marisa,
Messina Antonio,
Santarpino Giuseppe,
Santini Francesco,
Beghi Cesare,
Ratta Ester Della,
Troise Giovanni,
Fischlein Theodor,
Passerone Giancarlo,
Juvonen Tatu,
Mazzucco Alessandro,
Heikkinen Jouni,
Faggian Giuseppe
Publication year - 2014
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12365
Subject(s) - medicine , euroscore , intensive care unit , aortic valve replacement , artery , surgery , coronary artery bypass surgery , cardiology , derivation , stenosis
Background This multicenter study was undertaken to determine the immediate and long‐term outcomes in patients undergoing a primary surgical aortic valve replacement (AVR) who had a previous coronary artery bypass graft surgery with patent grafts. Methods One hundred and thirteen consecutive patients (mean EuroSCORE II, 10.3 ± 7.7%, median 8.0%) who underwent first‐time isolated AVR after coronary artery bypass grafting (CABG) were the subjects of this multicenter study. The procedure was performed through a full sternotomy in 95.7% of cases, a patent internal mammary artery graft was clamped in 76.6% of patients. The temperature of cardioplegia was ≤12 °C in 62.8% of patients and systemic temperature was <32 °C in 23.9% of patients. Results Thirty‐day mortality was 4.4%. Stroke was observed in 8.0% of patients, low cardiac output syndrome in 14.1%, prolonged tracheal intubation in 20.8%, and intensive care unit stay was longer than five days in 19.5% of patients. Among patients with a patent internal mammary graft (91 patients), clamping of this graft (5.7% vs. 0%, p = 0.57) was associated with a nonsignificant trend toward increased 30‐day mortality. One‐, three‐ and five‐year survival rates were 91.5%, 90.4%, and 88.4%, respectively. Conclusions Patients undergoing isolated AVR after prior CABG have a good immediate and late survival. A history of prior CABG should not be considered an absolute indication for transcatheter AVR. doi: 10.1111/jocs.12365 (J Card Surg 2014;29:450–454)