naa a22 4500 510728804 CHVBK 20180411082945.0 cr unu---uuuuu 180411e20131101xx s 000 0 eng 10.1007/s11748-013-0232-6 doi (NATIONALLICENCE)springer-10.1007/s11748-013-0232-6 Adding coronary artery bypass grafting to aortic valve replacement increases operative mortality for elderly (70years and older) patients with aortic stenosis [Elektronische Daten] [Yasuyuki Sasaki, Hidekazu Hirai, Mitsuharu Hosono, Yasuyuki Bito, Atsushi Nakahira, Yasuo Suehiro, Daisuke Kaku, Yuko Okada, Shigefumi Suehiro] Objective: This retrospective study aimed to determine the effect of simultaneous aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) on operative outcomes and long-term survival in elderly patients with a high prevalence of comorbidity. Methods: One hundred and fifty-seven elderly patients (70years old or older) undergoing isolated AVR (n=120) or combined AVR/CABG (n=37) were evaluated. Operative outcomes were compared between the two surgical groups. Long-term survival was also compared between the groups using the Kaplan-Meier method and long-rank (Mantel-Cox) test. Results: Operative mortality was 0.8% for the isolated AVR group and 5.4% for the combined AVR/CABG group (p=0.076). The length of the intensive care unit stay for the combined AVR/CABG group was significantly longer than that for the isolated AVR group (median: 40 vs. 21h, p=0.008). However, the occurrence rate of hospital complications, such as reoperation for bleeding, deep sternal infection, supra-ventricular arrhythmia, and neurological complications, was similar between the two groups. Actuarial survival at 3 and 5years was 82.3 and 80.9% for the isolated AVR group, and 88.3 and 73.0% for the combined AVR/CABG group, respectively (p=0.637). Conclusions: The satisfactory operative and long-term results in our study support a more aggressive simultaneous coronary revascularization combined with AVR for aortic valve stenosis in elderly patients. The Japanese Association for Thoracic Surgery, 2013 Aortic stenosis nationallicence Coronary artery bypass grafting nationallicence Aortic valve replacement nationallicence Elderly patients nationallicence Simultaneous AVR and CABG procedures nationallicence Sasaki Yasuyuki Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Hirai Hidekazu Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Hosono Mitsuharu Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Bito Yasuyuki Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Nakahira Atsushi Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Suehiro Yasuo Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Kaku Daisuke Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Okada Yuko Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut Suehiro Shigefumi Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/11(2013-11-01), 626-631 1863-6705 61:11<626 2013 61 11748 https://doi.org/10.1007/s11748-013-0232-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-013-0232-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sasaki Yasuyuki Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Hirai Hidekazu Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Hosono Mitsuharu Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Bito Yasuyuki Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Nakahira Atsushi Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Suehiro Yasuo Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Kaku Daisuke Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Okada Yuko Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 700 1- Suehiro Shigefumi Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, 545-8585, Osaka, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/11(2013-11-01), 626-631 1863-6705 61:11<626 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer