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Ann Thorac Surg 1980;29:440-443
© 1980 The Society of Thoracic Surgeons

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Articles

Combined Valve and Coronary Artery Surgery

Department of Surgery, Division of Cardiothoracic Surgery, and the Department of Medicine, Division of Cardiology, Long Island Jewish-Hillside Medical Center, New Hyde Park, and the State University of New York School of Medicine at Stony Brook, NY

Accepted for publication July 5, 1979.

^* Address reprint requests to Dr. Wisoff, Division of Cardiothoracic Surgery, Long Island Jewish-Hillside Medical Center, New Hyde Park, NY 11042

From 1970 to 1978, 79 patients (Group 1) underwent combined valve replacement and coronary bypass operation. They were compared with 79 consecutive subsequent patients (Group 2) undergoing similar valve replacement. In Group 1, 73% were men compared with 48% in Group 2. The average age in Group 1 was 60 years (range, 42 to 84 years) and in Group 2, 57 years (range, 29 to 74 years). When the patients were first seen, angina was present in 49% in Group 1 and only 24% in Group 2. More than 95% of the patients in both groups were in New York Heart Association Functional Class III or IV. Areas of abnormal contraction were twice as frequent in the angiograms of patients in Group 1 (43%). Thirty-three mitral, 44 aortic, and 2 aortic plus mitral valve replacements were performed in each group. One to 4 grafts were placed in each patient in Group 1, and most had single or double grafts. Early morbidity was more frequent in Group 1. Early mortality was 5 to 6% in each group. Late mortality (average, 3.5 years after operation) was 16 to 17% in each group. The working status and Functional Classification at follow-up were similar for patients in both groups. Combined valve and coronary operation carried a similar operative risk and had similar late results as valve replacement alone.

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