@article{oai:hirosaki.repo.nii.ac.jp:00005892,
 author = {Yu, Zaiqiang and Daitoku, Kazuyuki and Yang, Wei and Kondo, Norihiro and Minakawa, Masahito and Fukuda, Ikuo},
 issue = {2-4},
 journal = {弘前医学},
 month = {Mar},
 note = {Background: Combined aortic valve replacement（ AVR） and coronary artery bypass grafting（ABG）is mostly performed for patients with aortic stenosis（ AS） and coronary artery disease（ AD）.
Objectives: We aim to clarify that combined operation of AVR and CABG with adequate perioperative ardiac protection does not increase operative and postoperative risk.
Methods: A total of 217 patients who underwent AVR for aortic stenosis alone or combined AVR and CABG from 1/2002 to 12/2015 were recruited. The aortic valve alone group （group A） had 164 patients, with an average age of 71.6± 8.1 years. The combined operation group （group C） consisted of 54 patients, with an average age of 73.5±8.5 years. Aortic valve area and pressure gradient showed no significant differences between the two groups. In group C, an average of 2±0.8 vessels had CAD. Cold crystalloid cardioplegia according to left ventricular mass ± a terminal hot shot was used for all patients. Distal graft anastomosis was done after cardiac arrest and cardioplegia （1.5-fold normal） was injected additionally from the graft with severe proximal obstruction of the right coronary artery.
Results: Group C included more patients with diabetes mellitus （DM, 43.4% vs. 26.8%） and low left ventricular ejection fraction（ LVEF<50%, 33.96% vs. 16.46%） than group A. On the other hand, the incidence of atrial fibrillation（ AF, .77% vs. 13.41%） was significantly less in group C than in group A. Although cardiac arrest time was longer in group C,postoperative CPK-MB was not significantly elevated, except in 4 patients. Postoperative data showed no significant differences between the two groups.
Conclusions: In our department, satisfactory clinical outcomes were obtained with combined operation AVR and CABG. Sufficient myocardial protection had an important effect on clinical outcomes.},
 pages = {99--108},
 title = {Outcome of concomitant surgical treatment in patients with coronary artery disease and severe aortic stenosis: A single-center study},
 volume = {70},
 year = {2020}
}