[Surgical valve therapy combined with aorto-coronary bypass (author's transl)].

The AA. analyse a series of 720 patients who have undergone an aorta coronary by-pass combined with surgical valve therapy at the Texas Heart Institute up to an including 1977. 384 of these cases involved the aortic valve, 306 the mitral valve and 30 both valves. The combined operation was shown to be necessary since the disregarded or untreated coronary lesion in patients with valve pathology increases both the early and late mortality rate or reduces the results after surgical valve therapy. The double operation, on the other hand, reduces mortality, eliminates the symptoms, improves long-term survival and prevents myocardial infarction. Therefore emphasis is placed on the need for coronarographic investigation for valve patients over 40. However, the association of mitral or anuloplastic valve replacement does not lead to a significant improvement in long-term survival when mitral valve insufficiency is accompanied by an ischaemic aetiology.