Analysis of the quality of life in patients with coronary heart disease and concomitant aortic valve pathology in the long-term period after aortic valve replacement with myocardial revascularization
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Abstract
The aim – to conduct an analysis of the quality of life in the long-term period after the use of a hybrid approach, involving a combination of surgical aortic valve replacement (AVR) and endovascular methods of myocardial revascularization, in patients with coronary heart disease and an aortic valve disease.
Materials and methods. For this one-center study, medical records of adult patients (over 18 years old) who underwent surgical AVR along with myocardial revascularization in the period from 2018 to 2022 were selected.
Results and discussion. We selected 130 patients who underwent AVR together with myocardial revascularization (the first group (n = 51) – a combination of AVR and percutaneous coronary interventions (PCI); the second group
(n = 79) – a combination of AVR and coronary artery bypass grafting (CABG). Damage to the left main coronary artery was recorded by 5.60 times less often (p = 0.018) in the patients of the first group compared to the patients of the second group. The duration of cardiopulmonary bypass and aorta cross clamping in the patients of the first group was, respectively, by 1.5 times and by 1.4 times significantly lower compared to the second group (p = 0.0001). The pain index after 6 months according to the SF-36 questionnaire was found to be 13.5 % (p = 0.017) significantly higher in patients of the first group compared to the second group, while other indicators did not differ among the study groups.
Conclusions. Patients with the hybrid approach of treatment were characterized by a similar level of postoperative complications with the surgical group. At the same time, this cohort of patients had a better SF-36 pain index 6 months after the hybrid intervention.
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References
Katta N, Loethen T, Lavie CJ, Alpert MA. Obesity and Coronary Heart Disease: Epidemiology, Pathology, and Coronary Artery Imaging. Curr Probl Cardiol. 2021 Mar;46(3):100655. https://doi.org/10.1016/j.cpcardiol.2020.100655.
Goldsborough E 3rd, Osuji N, Blaha MJ. Assessment of Cardiovascular Disease Risk: A 2022 Update. Endocrinol Metab Clin North Am. 2022 Sep;51(3):483-509. https://doi.org/10.1016/j.ecl.2022.02.005.
Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. 2022 Feb 22;145(8):e153-e639. https://doi.org/10.1161/CIR.0000000000001052.
Manjunath CN, Agarwal A, Bhat P, Ravindranath KS, Ananthakrishna R, Ravindran R, Agarwal N. Coronary artery disease in patients undergoing cardiac surgery for non-coronary lesions in a tertiary care centre. Indian Heart J. 2014 Jan-Feb;66(1):52-6. https://doi.org/10.1016/j.ihj.2013.12.014.
Iung B. Interface between valve disease and ischaemic heart disease. Heart. 2000 Sep;84(3):347-52. https://doi.org/10.1136/heart.84.3.347.
Matta A, Moussallem N. Coronary artery disease is associated with valvular heart disease, but could it Be a predictive factor? Indian Heart J. 2019 May-Jun;71(3):284-7. https://doi.org/10.1016/j.ihj.2019.07.001.
Gallingani A, D’Alessandro S, Singh G, Hernandez-Vaquero D, Çelik M, Ceccato E, Nicolini F, Formica F. The impact of coronary artery bypass grafting added to aortic valve replacement on long-term outcomes in octogenarian patients: a reconstructed time-to-event meta-analysis. Interact Cardiovasc Thorac Surg. 2022 Jul 9;35(2):ivac164. https://doi.org/10.1093/icvts/ivac164.
Rzucidło-Resil JM, Stoliński J, Musiał R, Sobczyński R, Plicner D. Patients with aortic valve disease and coronary artery disease can benefit from a hybrid approach combining aortic valve replacement through right minithoracotomy and percutaneous coronary intervention. Kardiochir Torakochirurgia Pol. 2023 Sep;20(3):146-54. https://doi.org/10.5114/kitp.2023.131954.
Kraler S, Blaser MC, Aikawa E, Camici GG, Lüscher TF. Calcific aortic valve disease: from molecular and cellular mechanisms to medical therapy. Eur Heart J. 2022 Feb 12;43(7):683-97. https://doi.org/10.1093/eurheartj/ehab757.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83.
Shannon J, Colombo A, Alfieri O. Do hybrid procedures have proven clinical utility and are they the wave of the future?: hybrid procedures have proven clinical utility and are the wave of the future. Circulation. 2012 May 22;125(20):2492-503; discussion 2503. https://doi.org/10.1161/CIRCULATIONAHA.111.041186.
Byrne JG, Leacche M, Vaughan DE, Zhao DX. Hybrid cardiovascular procedures. JACC Cardiovasc Interv. 2008 Oct;1(5):459-68. https://doi.org/10.1016/j.jcin.2008.07.002.
Papakonstantinou NA, Baikoussis NG, Dedeilias P, Argiriou M, Charitos C. Cardiac surgery or interventional cardiology? Why not both? Let’s go hybrid. J Cardiol. 2017 Jan;69(1):46-56. https://doi.org/10.1016/j.jjcc.2016.09.007.
Leacche M, Umakanthan R, Zhao DX, Byrne JG. Surgical update: hybrid procedures, do they have a role? Circ Cardiovasc Interv. 2010 Oct;3(5):511-8. https://doi.org/10.1161/CIRCINTERVENTIONS.
George I, Nazif TM, Kalesan B, Kriegel J, Yerebakan H, Kirtane A, Kodali SK, Williams MR. Feasibility and Early Safety of Single-Stage Hybrid Coronary Intervention and Valvular Cardiac Surgery. Ann Thorac Surg. 2015 Jun;99(6):2032-7. https://doi.org/10.1016/j.athoracsur.2015.01.028.
Brinster DR, Byrne M, Rogers CD, Baim DS, Simon DI, Couper GS, Cohn LH. Effectiveness of same day percutaneous coronary intervention followed by minimally invasive aortic valve replacement for aortic stenosis and moderate coronary disease («hybrid approach»). Am J Cardiol. 2006 Dec 1;98(11):1501-3. https://doi.org/10.1016/j.amjcard.2006.08.010.
Santana O, Xydas S, Williams RF, Mawad M, Heimowitz TB, Pineda AM, Goldman HS, Mihos CG. Hybrid approach of percutaneous coronary intervention followed by minimally invasive mitral valve surgery: a 5-year single-center experience. J Thorac Dis. 2017 Jun;9(Suppl 7):S595-S601. https://doi.org/10.21037/jtd.2017.06.29.
Tabata M, Umakanthan R, Cohn LH, Bolman RM 3rd, Shekar PS, Chen FY, Couper GS, Aranki SF. Early and late outcomes of 1000 minimally invasive aortic valve operations. Eur J Cardiothorac Surg. 2008 Apr;33(4):537-41. https://doi.org/10.1016/j.ejcts.2007.12.037.
Lamelas J, Sarria A, Santana O, Pineda AM, Lamas GA. Outcomes of minimally invasive valve surgery versus median sternotomy in patients age 75 years or greater. Ann Thorac Surg. 2011 Jan;91(1):79-84. https://doi.org/10.1016/j.athoracsur.2010.09.019.
Byrne JG, Leacche M, Unic D, Rawn JD, Simon DI, Rogers CD, Cohn LH. Staged initial percutaneous coronary intervention followed by valve surgery («hybrid approach») for patients with complex coronary and valve disease. J Am Coll Cardiol. 2005 Jan 4;45(1):14-8. https://doi.org/10.1016/j.jacc.2004.09.050.
Kuchulakanti P, Rha SW, Satler LF, Suddath WO, Pichard AD, Kent KM, Weissman NJ, Cheneau E, Pakala R, Canos DA, Pinnow EE, Waksman R. Safety of percutaneous coronary intervention alone in symptomatic patients with moderate and severe valvular aortic stenosis and coexisting coronary artery disease: analysis of results in 56 patients. J Invasive Cardiol. 2004 Dec;16(12):688-91.
Santana O, Funk M, Zamora C, Escolar E, Lamas GA, Lamelas J. Staged percutaneous coronary intervention and minimally invasive valve surgery: results of a hybrid approach to concomitant coronary and valvular disease. J Thorac Cardiovasc Surg. 2012 Sep;144(3):634-9. https://doi.org/10.1016/j.jtcvs.2011.11.008.
Ranucci M, Ballotta A, Agnelli B, Frigiola A, Menicanti L, Castelvecchio S. Surgical and Clinical Outcome Research (SCORE) Group. Acute kidney injury in patients undergoing cardiac surgery and coronary angiography on the same day. Ann Thorac Surg. 2013 Feb;95(2):513-9. https://doi.org/10.1016/j.athoracsur.2012.09.012.