REPORTED FREQUENCY OF CORONARY ARTERIAL NARROWING BY ANGIOGRAM IN PATIENTS WITH VALVULAR AORTIC-STENOSIS

During the past 25 years most patients aged >40 years of age having aortic valve replacement have had coronary angiography preoperatively. At least 33 studies have reported the frequency of significant (>50% diameter reduction) coronary arterial narrowing in patients with valvular aortic stenosis, and most of these reported studies included only patients who had the stenotic valve replaced with a prosthesis or bioprosthesis1-33 (Table I). Patients with mitral valve dysfunction usually were excluded. Analysis of the studies, which unfortunately also included a small percentage of patients <40 years of age, disclosed that 37% of the patients (1,302 of 3,509) had significant narrowing by angiogram of 1 or more major epicardial coronary arteries.