COMBINED VALVE AND CORONARY-ARTERY BYPASS-SURGERY - EARLY AND LATE RESULTS

Determinants of early, late and event-free survival of combined valve and coronary artery bypass graft (CABG) surgery were studied in 420 pa tients using multivariate analysis. It was found that the risk of hosp ital death increases 5 times when the preoperative NYHA class was grea ter-than-or-equal-to IV, 3 times when left ventricular (LV) function i s significantly impaired and is double when mitral regurgitation is pr esent. The survival probability of hospital survivors was 91% (87.3-94 .5%) at 5 years. Late mortality was determined by advanced preoperativ e NYHA class (greater-than-or-equal-to IV) and the presence of mitral regurgitation. The event-free survival probability of hospital survivo rs, i.e. total events including death, valve-related complications, is chemic complications and recurrent NYHA class greater-than-or-equal-to IV, was 73.0% (66.7 - 79.5%) at 5 years. Postoperative events were de termined by the presence of preoperative NYHA class greater-than-or-eq ual-to IV, impaired ventricular function, mitral regurgitation and non -sinus rhythm. It is concluded that these parameters can be considered as the most important predictors of clinical outcome after combined v alve and CABG surgery.