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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Prevalence of coronary atherosclerosis in patients with aortic valve replacement

J P Ottervanger, K Thomas, T H Sie

    Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
    |February 20, 2015
    PubMed

    Insights

    Preoperative coronary angiography remains crucial for patients undergoing aortic valve replacement, as coronary artery disease prevalence is high and has not significantly changed over a decade. This ensures optimal patient care and surgical planning.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Diagnostic Imaging

    Background:

    • Coronary artery disease (CAD) is common in patients with aortic valve disease, necessitating preoperative coronary angiography before aortic valve replacement (AVR).
    • Despite declining CAD mortality in the general population, the necessity of routine preoperative angiography for all AVR patients remains uncertain.

    Purpose of the Study:

    • To determine the prevalence of angiographically defined CAD in patients undergoing AVR.
    • To analyze trends in CAD prevalence over a ten-year period (1988-1998) in this patient cohort.

    Main Methods:

    • Retrospective cross-sectional study of 1181 patients undergoing AVR between 1988 and 1998.
    • Exclusion of patients with prior CAD history or younger than 25 years.
    • Definition of coronary atherosclerosis as ≥50% stenosis in one or more coronary arteries via preoperative angiography.

    Main Results:

    • Coronary atherosclerosis was detected in 40% of patients (472/1181) on preoperative angiography.
    • Prevalence of CAD varied annually between 30% and 50% but showed no significant trend over the study period.
    • Known ischemic heart disease risk factors were associated with the presence of CAD.

    Conclusions:

    • The prevalence of angiographically confirmed CAD in patients awaiting AVR remains high.
    • No significant temporal change in CAD prevalence was observed between 1988 and 1998.
    • Preoperative coronary angiography is recommended for all patients prior to AVR due to the persistent high prevalence of CAD.
    Abstract

    Keywords:
    angiographyaortic valve replacementcoronary heart diseaseepidemiology

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