[Prospective study of the prevalence of coronary involvement in isolated aortic stenosis]

From 1980 to 1982, 148 consecutive patients with isolated aortic stenosis (AS) were studied prospectively with coronary angiography. Significant coronary artery disease was discovered in 27 patients (18.4 percent of cases), with involvement of the left main coronary artery 4 times (15 percent of cases), three-vessel involvement 10 times (37 percent of cases), two-vessel involvement 8 times (30 percent of cases), and single-vessel involvement 9 times (33 percent of cases). Clinical information such as age, sex, the existence of angina (present in 81 out of 148 patients, or 54.7 percent of cases), or electrocardiographic findings could not accurately predict coronary artery involvement except for the previous history of a myocardial infarction. Five patients with coronary artery lesions had no manifestations of angina, comprising 18.5 percent of patients with coronary artery disease, 3.4 percent of the entire group of 148 patients with AS, and 7 percent of patients without angina. This study's originality resides in the fact that it is a prospective study which demonstrates that coronary artery lesions associated with AS can often be severe and can not be predicted without coronary angiography. No other examination can reliably identify the association of these two conditions, making coronary angiography a routine part of the preoperative evaluation of AS if these lesions are to be discovered.