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Surgery for Combined Valvular and Coronary Heart Disease

Floyd D. Loop, MD; Rene G. Favaloro, MD; Earl K. Shirey, MD; Laurence K. Groves, MD; Donald B. Effler, MD
JAMA. 1972;220(3):372-376. doi:10.1001/jama.1972.03200030032008.
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Valvular heart disease, regardless of its etiology or chronicity, offers no protection against coronary atherosclerosis. Fifty patients with combined valve and coronary heart disease required aortocoronary bypass grafts in addition to valve reconstruction or replacement. The operative mortality was 8%. Twenty-three of 27 patients for whom follow-up has been more than six months after surgery (average: 14.8 months) are active or have returned to work. Only one patient experiences angina pectoris postoperatively and no myocardial infarctions have occurred in the late period. Eighteen patients underwent a second cardiac catheterization after an average interval of nine months and 24 of 26 grafts (92%) are patent. This review emphasizes the necessity for cinecoronary arteriography in the preoperative evaluation of valvular heart disease.


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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