Combined surgery for valve and coronary artery disease
Bruce W. Lytle, MD
Department of Cardiothoracic Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44106
Patients with valvular heart disease often have coexisting coronary artery disease. Studies of the first 500 patients undergoing aortic valve replacement (AVR) combined with coronary bypass grafting (1967–1981) and the first 300 patients undergoing mitral valve replacement (MVR) combined with coronary bypass grafting (1970–1983) at the Cleveland Clinic documented overall in-hospital mortality at 5.9% and 7.3%, respectively. Late survival of patients after AVR and bypass grafting exceeded that for patients after MVR and bypass grafting. In both groups, patients who received bioprostheses and who did not take warfarin had superior survival.