Parravicini R, Modena M G, Sandiford F M
G Ital Cardiol. 1980;10(11):1508-19.
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.
作者分析了截至1977年（含1977年）在德克萨斯心脏研究所接受主动脉冠状动脉搭桥术联合外科瓣膜治疗的720例患者。其中384例涉及主动脉瓣，306例涉及二尖瓣，30例涉及两个瓣膜。由于瓣膜病变患者中被忽视或未治疗的冠状动脉病变会增加早期和晚期死亡率，或降低外科瓣膜治疗后的效果，因此联合手术被证明是必要的。另一方面，双手术可降低死亡率、消除症状、提高长期生存率并预防心肌梗死。因此，重点强调了对40岁以上瓣膜病患者进行冠状动脉造影检查的必要性。然而，当二尖瓣关闭不全伴有缺血病因时，二尖瓣或瓣环成形术置换术联合应用并不会显著改善长期生存率。
