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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Preoperative use and safety of coronary angiography for acute aortic valve infective endocarditis

Guillaume Hekimian1, Myongchan Kim, Stephanie Passefort

  • 1Cardiology Department, APHP and University Paris, Bichat Hospital, Paris, France.

Heart (British Cardiac Society)
|April 29, 2010
PubMed

Insights

Preoperative coronary angiography (CA) in patients with aortic valve infective endocarditis (AV-IE) is safe and recommended for those with cardiovascular risk factors. This procedure did not increase mortality or worsen renal function, supporting current guidelines.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • Preoperative coronary angiography (CA) is recommended for patients with acute aortic valve infective endocarditis (AV-IE) and high cardiovascular risk.
  • However, evidence is limited, and risks include vegetation dislodgement and contrast-induced nephropathy.

Purpose of the Study:

  • To review the use, indications, and complications of preoperative CA in patients with AV-IE.
  • To evaluate the safety and impact of CA on patient outcomes.

Main Methods:

  • Retrospective study of 83 patients operated on for AV-IE between January 2002 and March 2007.
  • Analysis of CA use, findings, and associated complications.

Main Results:

  • CA was performed preoperatively in 36 (43%) patients.
  • No embolic events occurred post-CA. Preoperative CA was not associated with increased in-hospital mortality or worsening renal function.
  • Patients undergoing CA tended to be healthier, but anatomical lesions were similar.

Conclusions:

  • Preoperative CA can be performed safely in selected AV-IE patients with cardiovascular risk factors.
  • The findings support current guidelines recommending CA before surgery in these patients.
Abstract

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