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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Prognostic Impact of Untreated Chronic Coronary Artery Obstruction After Surgery for Aortic Regurgitation

Xin Li1,2, Vito Domenico Bruno3, Yi Jiang1,2

  • 1Department of Cardiovascular Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical College, Nanjing 210008, China.

Journal of Cardiovascular Development and Disease
|March 27, 2026
PubMed

Insights

For patients with aortic regurgitation (AR) undergoing valve surgery, moderate coronary artery stenosis (50-70%) does not worsen surgical outcomes or long-term survival. This finding clarifies management strategies for coronary obstruction in AR patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Vascular Medicine

Background:

  • Optimal management of moderate (50-70%) chronic coronary artery stenosis in patients with aortic regurgitation (AR) undergoing aortic valve surgery is debated.
  • This study investigates the prognostic significance of coronary obstruction severity on surgical outcomes and survival in AR patients.

Purpose of the Study:

  • To evaluate the impact of 50-70% chronic coronary obstruction on major adverse cardiovascular events (MACE) and all-cause mortality in patients undergoing aortic valve surgery for AR.
  • To compare surgical outcomes between patients with <50% and 50-70% coronary stenosis.

Main Methods:

  • Retrospective cohort study of 717 patients undergoing aortic valve surgery for AR.
  • Patients were grouped by coronary stenosis severity (<50% vs. 50-70%).
  • 1:1 propensity score matching was used, comparing 72 patients in each group regarding MACE and all-cause death.

Main Results:

  • No significant differences in perioperative mortality or complication rates between the groups.
  • Median follow-up was 2.53 years.
  • 50-70% coronary obstruction did not significantly increase MACE (HR=2.050) or all-cause mortality (HR=0.710), confirmed by regression analyses.

Conclusions:

  • Moderate (50-70%) chronic coronary obstruction does not adversely affect perioperative complications, MACE, or all-cause mortality in patients with AR undergoing aortic valve surgery.
  • These findings support current management strategies for moderate coronary stenosis in this patient population.
Abstract

Keywords:
aortic regurgitationcoronary artery diseasevalve disease

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