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Clinical presentation, surgical management, and outcomes of patients treated for aortic stenosis and coronary artery disease. Does age matter?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Perek, Bartłomiej Casadei, Veronica Puślecki, Mateusz Stefaniak, Sebastian Maison, Dawid Gwizdała, Adrian Perek, Anna Szarpak, Łukasz Jemielity, Marek M. |
| Copyright Year | 2014 |
| Abstract | BACKGROUND Aortic stenosis and coronary artery disease (CAD) sharing similar risk factors are associated with aging of the human population. AIM The purpose of this study was to examine whether age affects clinical presentation, intraoperative management, and outcomes of patients who undergo simultaneous operations of aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). METHODS The study involved 452 consecutive patients aged 64.8 ± 8.2 years (range 38-79 years), who underwent combined AVR and CABG between 2005 and 2015. They were divided into three groups: Y (young; below the first quartile; n = 114), M (middle-aged; 58-71 years; n = 225) and E (elderly; above the third quartile; n = 113). Pre- and intraoperative variables were analysed. The deaths that occurred in hospital and throughout follow-up were defined as cardiac- or non-cardiac-related. The probability of survival was calculated with the use of Kaplan-Meier curves. RESULTS Coronary artery disease was more extensive in group E than in group Y (p < 0.05). Complete myocardial revasculari-sation was performed in 94.1%, 76.2%, and 62.8% in groups Y, M, and E, respectively (p < 0.05). In-hospital mortality was 2.0%, 5.3%, and 6.4%, in groups Y, M, and E, respectively. Early morbidity was significantly higher in group E than in groups M or Y. The 12- and 60-month freedom from cardiac-related death was higher in group Y (0.98 ± 0.02 and 0.94 ± 0.03) than in group E (0.93 ± 0.02 and 0.85 ± 0.03; p = 0.023, respectively). Left ventricular ejection fraction below 0.4 and incomplete revascularisation were associated with worse prognosis, particularly in group E. CONCLUSIONS Elderly patients undergoing combined procedures of AVR and CABG having more extensive CAD less often receive complete revascularisation, are at higher risk of early organ failure, and present markedly reduced rates of freedom from cardiac-related deaths throughout follow-up than younger subjects. |
| Starting Page | 655 |
| Ending Page | 661 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://ojs.kardiologiapolska.pl/kp/article/download/KP.2018.0005/9409 |
| PubMed reference number | 29313564v1 |
| Alternate Webpage(s) | https://doi.org/10.5603/KP.2018.0005 |
| DOI | 10.5603/KP.2018.0005 |
| Journal | Kardiologia polska |
| Volume Number | 76 |
| Issue Number | 3 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Aortic Valve Insufficiency Aortic Valve Stenosis Arteriopathic disease Cessation of life Coronary Artery Bypass Surgery Coronary Artery Disease Ejection fraction (procedure) Forecast of outcome Liver Failure, Acute Morbidity - disease rate Myocardial Ischemia Patients Replacement of aortic valve (procedure) Surgical Management revascularization |
| Content Type | Text |
| Resource Type | Article |
