Comparative Study On Left Ventricular Function Before And After Cardiac Valve Surgery And Concomitant Coronary Artery Bypass Grafting

Objective:The number of elderly patients undergoing cardiac valve surgery combined with coronary artery bypass grafting(CABG)is rising and this type of cardiac surgery is complicated with the most complications.Our aim is to evaluate the short-term therapeutic effect on left ventricular function after cardiac valve surgery combined with coronary artery bypass grafting and early major post-operation complications in these patients,which can be the reference for clinical practice,and enhance the therapeutic effect.Methods:Patients who underwent cardiac valve surgery combined with coronary artery bypass grafting were enrolled from January 1st in 2015 to December 31st in 2016.Echocardiographic parameters including left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular shoot ejection fraction(LVEF),and NYHA classification were detected and compared at pre-operation,1 week,3 months,and 1 year post-operation to evaluate the therapeutic effects.The incidence of severe complications and mortality were recorded.Results:One-hundred and two patients underwent cardiac valve surgery combined with coronary artery bypass grafting,including 118 males and 34 females,whose mean age was(61.53±7.14)years old.There were 76 cases of degenerative valve disease,60 cases of rheumatic valve disease,13 cases with congenital valve disease,and 3 cases of other types of valve disease.Ninety-four patients received mechanical valve replacement while twenty-one patients received biological valve replacement.The mean number of grafted vessels was(1.69±0.79).The cardiac functions of patients were significantly improved after the operations compared with the preoperative conditions.The echocardiography showed that LVEDD and LVESD were obviously decreased(P<0.001)and LVEF increased significantly(P<0.001)at pre-operation,1 week,3 months,and 1 year post-operation.Multiple comparisons of different parameter at different follow-up time points revealed that the postoperative cardiac function was significantly improved than that at pre-operation.There was no statistically significant difference in the improvement of LVEF in consideration of factors,such as age,sex and number of grafted vessels.In the hospital,overall in-hospital mortality was 6.58%,and postoperative complications occurred in 47 patients.Symptoms were relieved after treatment and all of the patients were recovered.Conclusion:Cardiac valve surgery combined with coronary artery bypass grafting is a vital and therapeutic treatment for patients with cardiac valve disease and coronary artery disease.It is of great importance to make a thorough assessment of patients’conditions before operation.Rational use of vasoactive drugs and timely treatment of postoperative complications should be required to improve the quality of life and prognosis.The valve surgery combined with coronary artery bypass grafting has a remarkable effect,but the long-term effect is an ongoing topic of research.