What is recommended for patients with concomitant valvular disease undergoing CABG?
Patients undergoing CABG who have at least moderate aortic stenosis should have concomitant aortic valve replacement. Patients undergoing CABG who have severe ischemic mitral valve regurgitation not likely to resolve with revascularization should have concomitant mitral valve repair or replacement at the time of CABG. In patients undergoing CABG who have moderate ischemic mitral valve regurgitation not likely to resolve with revascularization, concomitant mitral valve repair or replacement at the time of CABG is reasonable. Patients undergoing CABG who have mild aortic stenosis may be considered for concomitant aortic valve replacement when evidence (eg, moderate severe leaflet calcification) suggests that progression of the aortic stenosis may be rapid and the risk of the combined procedure is acceptable.