A 20-year UK multi-center experience of combined surgical aortic valve replacement and coronary artery bypass grafting

BACKGROUND: Concomitant surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) generally carries a higher operative mortality than isolated SAVR or CABG but also conveys survival benefit. Our aim was to identify factors associated with adverse short and long-term outcomes in this patient group. RESEARCH DESIGN AND METHODS: All consecutive patients undergoing first-time SAVR & CABG in two cardiac surgery centers between 2004 and 2024 were included. Primary outcomes were in-hospital & 1-year mortality and overall survival. Secondary outcomes were post-operative complications and post-operative length of stay (PLOS). Cox multivariable regression was used to identify variables independently associated with overall survival. RESULTS: = 94). Median follow-up time was 82 months (49-119) and estimated median overall survival was 106 months (102-110). Despite higher early mortality, receiving a greater number of grafts was independently associated with improved long-term survival. CONCLUSIONS: Findings from this study suggest that SAVR & CABG remains a safe and effective treatment option for appropriately selected patients with acceptable peri-operative morbidity and reassuring long-term durability.