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Distribution of coronary artery disease in patients with isolate aortic valve disease
Insights
Coronary artery disease (CAD) is common in men with aortic valve disease, especially those needing aortic valve replacement (AVR). Selective coronary arteriography is recommended for these male patients to identify associated CAD.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Aortic valve disease is a significant cardiovascular condition.
- Associated coronary artery disease (CAD) can complicate management and outcomes.
Purpose of the Study:
- To investigate the prevalence of CAD in adult patients with isolated aortic valve disease.
- To determine the correlation between aortic valve disease severity and the presence of CAD.
- To assess the diagnostic utility of coronary arteriography in this patient population.
Main Methods:
- Coronary arteriography was performed on 44 adult patients with isolated aortic valve disease.
- Patients were categorized based on the type and severity of aortic valve disease.
- Prevalence and patterns of CAD were analyzed, with a focus on affected coronary arteries.
Main Results:
- Seventy percent of patients required aortic valve replacement (AVR).
- Significant CAD was found in 59% of men with severe aortic stenosis, 33% with severe aortic regurgitation, and 50% with mixed disease undergoing AVR.
- Thirty-six percent of men with aortic valve disease not requiring AVR also had significant CAD.
- The left anterior descending artery was most frequently involved (84%), with multivessel disease being common.
- CAD was not observed in the 5 female patients studied.
Conclusions:
- Significant CAD is frequently associated with isolated aortic valve disease in adult men.
- The high prevalence of CAD in this cohort supports routine coronary arteriography when AVR is considered.
- Gender appears to influence the association between aortic valve disease and CAD.
Abstract:
Forty-four adult patients with isolated aortic valve disease underwent coronary arteriography. Seventy precent of patients required aortic valve replacement (AVR). Of 28 men who underwent AVR, 59 percent of those with severe aortic stenosis, 33 percent of those with severe aortic regurgitation and 50 percent of those with mixed aortic stenosis/aortic regurgitation had associated coronary artery disease. Thirty-six percent of men with aortic valve disease not requiring AVR had significant coronary artery disease (CAD). CAD was not found in the 5 female patients studied. In the patients with CAD, the left anterior descending artery was involved 84 percent of the time. Next in frequency were the right coronary artery, the proximal left circumflex artery, and the obtuse marginal artery. Multivessel disease was the rule. All but one patient with significant CAD had angina pectoris, but many patients with angina had normal coronary arteries. The frequent occurence of significant CAD in adult male patients with isolated aortic valve disease argues for the performance of selective coronary arteriography in all such patients in whom AVR is a consideration.