Revealing of Initial Factors Defining Results of Operation in Patients with Aortic Valve Replacement and Coronary Artery Disease

Moderate aortic valve stenosis is a common condition in patients with coronary heart disease (Gullinov and Garsia, 2005). Recent studies have shown that progression of aortic valve stenosis depends on the degree of valvular leaflets calcification; that aortic valve replacement does not increase mortality after coronary artery bypass grafting (CABG); moreover,valve replacement performed after CABG leads to decreased mortality, it was especially confirmed in patients with severe aortic valve stenosis. However, review of the literature concerning integration of the mathematical approaches in medicine has demonstrated that, the simple prognosis is more significant than an evaluation based on organ and system modeling for choice of treatment method and options for patients with such combined pathology. Repeated intervention is one of the most significant prognostic factors. Thus, after analyzing of 13,346 CABG cases Yap et al (2007) have shown that mortality of repeated interventions is approximately 3 times higher than that of primary interventions (4.8% and 1.8%, respectively). Patient’s age is another such a factor. Urso et al. (2007) have established that one-year survival after aortic valve replacement in patients aged over 80 years (86,1%) is significantly less than that in the younger group. Analyzing of 1567 patients after valve replacement combined with CABG, Doenst et al.(2006) have demonstrated patients’ gender influence on surgery outcomes, postoperatively women had higher stroke possibility (risk index was 1.52). We believe that various influences of parameters characterizing patient’s baseline status on surgery outcome require more complex multivariate statistical analysis to be used. It allows defining rational number of the most significant factors determining the surgery prognosis related both to baseline status of patients with heart defects and immediate postoperative complications caused by interventional injury and heart hemodynamic changes (1, 2, 3, 4, 5, 6). Moreover, one of the authors of the article (Wann and Balkhy, 2009) considers that application of the most modern diagnostics tests (i.e. computed tomography coronary angiography) allows predicting an outcome of the scheduled surgery more accurately.