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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Aortic valve surgery following previous coronary artery bypass grafting. Impact of calcification and leaflet movement

T Eitz1, G Kleikamp, K Minami

  • 1Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center of North-Rhine-Westfalia, Bad Oeynhausen, Germany.

International Journal of Cardiology
|August 4, 1998
PubMed

Insights

Patients undergoing aortic valve replacement after coronary artery bypass grafting often have rapidly progressing aortic valve disease. Early signs like calcification or impaired motion suggest considering aortic valve replacement during initial coronary artery bypass grafting surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Valvular Heart Disease

Background:

  • Aortic valve replacement (AVR) after coronary artery bypass grafting (CABG) carries high mortality.
  • Rapid progression of aortic valve disease is a concern in these patients.

Purpose of the Study:

  • To evaluate the progression of aortic valve disease in patients who underwent AVR after prior CABG.
  • To identify predictors of rapid aortic valve disease progression in this patient cohort.

Main Methods:

  • Retrospective review of 27 patients undergoing AVR post-CABG.
  • Analysis of cardiac catheterization data, including aortic valve pressure gradients.
  • Assessment of aortic valve calcification and leaflet motion from pre-AVR cardiac catheterization films.

Main Results:

  • Aortic valve disease, primarily aortic stenosis, progressed rapidly between CABG and AVR (mean interval 4.6 years).
  • Aortic valve peak-to-peak pressure gradient increased significantly from 20.2 mmHg to 63.0 mmHg.
  • High incidence of aortic valve calcification (81.5%) and impaired leaflet motion (81.5%) was observed at the time of CABG.

Conclusions:

  • Aortic valve disease progression is rapid in patients requiring AVR after CABG.
  • Pre-existing aortic valve calcification or impaired motion at the time of CABG may indicate a high risk for rapid progression.
  • Consider AVR during CABG not only based on hemodynamic criteria but also if aortic valve calcification or impaired motion is present.

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