Late results of combined mitral valve replacement and coronary bypass surgery

P. H. Kay, D. L. Nunley, G. L. Grunkemeier, C. W. Pinson, Albert Starr

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The incremental risk of coronary bypass surgery was analyzed in 718 patients undergoing mitral valve replacement between 1971 and 1983. Ninety-eight patients (14%) had significant coronary artery disease requiring coronary bypass surgery. In 70 of these patients, the origin of the mitral valve disease was nonischemic, whereas 28 patients had ischemic mitral regurgitation unsuitable for conservative valve surgery. There were six operative deaths (9%) and four perioperative myocardial infarctions (6%) after mitral valve replacement and coronary bypass surgery for nonischemic mitral valve disease. Operative mortality was related to low output cardiac failure before operation or perioperative myocardial infarction. Actuarial curves predict survival (± standard error) of 55 ± 7% at 5 years and 43 ± 8% at 10 years. Preoperative functional class was the only significant predictor of long-term survival in this group (p <0.05). The actuarial survival of the 620 patients without coronary artery disease who underwent mitral valve replacement alone was 63 ± 3% at 10 years. This was significantly better than that of the 70 patients who underwent mitral valve replacement and coronary bypass surgery for nonischemic mitral valve disease (p <0.001). Conversely, 5 year survival of the 28 patients with ischemic mitral regurgitation was 43 ± 10%. This confirms the negative detrimental effect of an ischemic origin of mitral valve disease on survival after mitral valve replacement and coronary bypass surgery (p <0.0001).

Original languageEnglish (US)
Pages (from-to)29-33
Number of pages5
JournalJournal of the American College of Cardiology
Volume5
Issue number1
StatePublished - 1985
Externally publishedYes

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Mitral Valve
Survival
Mitral Valve Insufficiency
Coronary Artery Disease
Myocardial Infarction
Heart Failure
Mortality

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Kay, P. H., Nunley, D. L., Grunkemeier, G. L., Pinson, C. W., & Starr, A. (1985). Late results of combined mitral valve replacement and coronary bypass surgery. Journal of the American College of Cardiology, 5(1), 29-33.

Late results of combined mitral valve replacement and coronary bypass surgery. / Kay, P. H.; Nunley, D. L.; Grunkemeier, G. L.; Pinson, C. W.; Starr, Albert.

In: Journal of the American College of Cardiology, Vol. 5, No. 1, 1985, p. 29-33.

Research output: Contribution to journalArticle

Kay, PH, Nunley, DL, Grunkemeier, GL, Pinson, CW & Starr, A 1985, 'Late results of combined mitral valve replacement and coronary bypass surgery', Journal of the American College of Cardiology, vol. 5, no. 1, pp. 29-33.
Kay, P. H. ; Nunley, D. L. ; Grunkemeier, G. L. ; Pinson, C. W. ; Starr, Albert. / Late results of combined mitral valve replacement and coronary bypass surgery. In: Journal of the American College of Cardiology. 1985 ; Vol. 5, No. 1. pp. 29-33.
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