PMID- 3872643
OWN - NLM
STAT- MEDLINE
DCOM- 19850502
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 39
IP  - 4
DP  - 1985 Apr
TI  - Risks of mitral valve replacement and mitral valve replacement with coronary 
      artery bypass.
PG  - 346-52
AB  - One hundred thirty consecutive patients who underwent mitral valve replacement 
      (MVR) or MVR with coronary artery bypass grafting (CABG) using cold crystalloid 
      cardioplegic solution were analyzed to determine operative mortality and risk 
      factors. Twenty-eight patients had mitral stenosis (MS), 37 had mitral 
      regurgitation (MR), 37 had mixed MS and MR, 23 had MR with coronary artery 
      disease (CAD), and 5 had MS with CAD. Preoperative pulmonary artery pressure, 
      pulmonary capillary wedge pressure, and cardiac index were not different among 
      groups, but patients with MR and CAD had a significantly higher left ventricular 
      end-diastolic pressure (LVEDP) and a significantly lower ejection fraction than 
      other groups. Mortality was 7.1% for patients with MS, 5.4% for MR, 8.1% for 
      mixed MS and MR, 0 for MS with CAD, and 21.7% for MR and CAD. Overall mortality 
      was 9.2%. Eleven patients had emergency operations for cardiogenic shock with a 
      mortality of 45%. Nineteen additional patients in New York Heart Association 
      (NYHA) Functional Class IV had MVR or MVR plus CABG with a mortality of 26%. 
      Sixteen patients required intraaortic balloon pump assistance, and 9 survived. 
      Four patients with MR and CAD required the left ventricular assist device, and 3 
      survived. Excluding patients who had emergency operations, overall mortality was 
      5.8%. Excluding patients who had emergency operations and patients in NYHA 
      Functional Class IV, overall mortality was 2%. Factors associated with death were 
      cardiogenic shock, NYHA Class IV, LVEDP greater than 15 mm Hg (16% mortality), 
      and age greater than 60 years (15% mortality).
FAU - Magovern, J A
AU  - Magovern JA
FAU - Pennock, J L
AU  - Pennock JL
FAU - Campbell, D B
AU  - Campbell DB
FAU - Pierce, W S
AU  - Pierce WS
FAU - Waldhausen, J A
AU  - Waldhausen JA
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Coronary Artery Bypass
MH  - Coronary Disease/complications/mortality/surgery
MH  - Female
MH  - *Heart Valve Prosthesis/mortality
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/mortality/physiopathology/*surgery
MH  - Mitral Valve Stenosis/mortality/physiopathology/*surgery
MH  - Postoperative Complications
MH  - Risk
MH  - Shock, Cardiogenic/etiology
EDAT- 1985/04/01 00:00
MHDA- 1985/04/01 00:01
CRDT- 1985/04/01 00:00
PHST- 1985/04/01 00:00 [pubmed]
PHST- 1985/04/01 00:01 [medline]
PHST- 1985/04/01 00:00 [entrez]
AID - S0003-4975(10)62628-8 [pii]
AID - 10.1016/s0003-4975(10)62628-8 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 1985 Apr;39(4):346-52. doi: 10.1016/s0003-4975(10)62628-8.