| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;70:778-783
© 2000 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery, Carlyle Fraser Heart Center, Department of Surgery, Atlanta, Georgia, USA
b Emory Center of Outcomes Research, Atlanta, Georgia, USA
c Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
Address reprint requests to Dr. Guyton, The Emory Clinic, 1365 Clifton Rd, Atlanta, GA 30322
e-mail: rguyton{at}emory.edu
Presented at the Forty-sixth Annual Meeting of the Southern Thoracic Surgical Association, San Juan, Puerto Rico, November 4–6, 1999.
Background. Outcomes and resource utilization of patients undergoing mitral valve replacement (MVR) with or without concomitant coronary artery bypass grafting (CABG) were reviewed.
Methods. Data for 1,844 patients undergoing isolated primary MVR at Emory University Hospitals between 1980 and 1997 were recorded prospectively in a computerized database.
Results. The four groups included patients undergoing elective MVR with (n = 360) or without CABG (n = 1332) and urgent/emergent MVR with (n = 66) or without CABG (n = 86). Length of stay was significantly higher in patients undergoing elective MVR with CABG (15 days) than in those without CABG (11 days) but was not significantly different in patients undergoing urgent/emergent MVR with CABG (17 days) than in those without CABG (19 days). In-hospital mortality was significantly higher for patients undergoing elective (14%) or urgent/emergent (41%) MVR with CABG than in those undergoing MVR without CABG (elective:6%; urgent/emergent:20%). The 19-year survival rate was 32% for patients undergoing elective MVR with CABG compared with 51% for those without CABG and 28% for patients undergoing urgent/emergent MVR with CABG compared with 46% for those without CABG. Multivariate correlates of long-term mortality included older age, concomitant CABG, and urgent/emergent status. Hospital costs were significantly higher for patients undergoing elective MVR with ($33,216) than for those without ($23,890) CABG. No significant difference in cost were noted between patients undergoing urgent/emergent MVR with ($40,535) and without ($31,981) CABG.
Conclusions. The addition of CABG or urgent/emergent status to patients undergoing MVR significantly increases morbidity, mortality, and costs. Careful scrutiny of the benefits versus resource utilization is required for patients undergoing high risk MVR.
Related Article
Ann. Thorac. Surg. 2000 70: 783-784.
This article has been cited by other articles:
|
|
 |
|
  T. Gudbjartsson, T. Absi, and S. Aranki Mitral Valve Replacement Card. Surg. Adult, January 1, 2008; 3(2008): 1031 - 1068. [Full Text]
|
|
|
|
 |
|
 M. F. Ibrahim, D. Paparella, J. Ivanov, M. R. Buchanan, and S. J. Brister Gender-related differences in morbidity and mortality during combined valve and coronary surgery J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 959 - 964. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. H. Thourani, W. S. Weintraub, R. A. Guyton, E. L. Jones, W. H. Williams, S. Elkabbani, and J. M. Craver Outcomes and Long-Term Survival for Patients Undergoing Mitral Valve Repair Versus Replacement: Effect of Age and Concomitant Coronary Artery Bypass Grafting Circulation, July 22, 2003; 108(3): 298 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Gudbjartsson, S. Aranki, and L. H. Cohn Mechanical/Bioprosthetic Mitral Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 951 - 986. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
