ORIGINAL ARTICLES   

Minerva Cardioangiologica 2002 August;50(4):343-6

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Severe aortic valve stenosis and coronary dis-ease in the elderly. Epidemiology and hemo-dynamic features

Rigatelli G., Franco G. F., Gemelli M., Bolomini L., Rossi P., Rigatelli G.

Background. Aortic valve replacement is an effective and safe intervention in the ederly, but to-day the prevalence of coronary artery disease in the ederly has still to be clarified. Aim of this paper is to analyze in a retrospective study the epidemyology and the hemodynamic relation of the association of severe aortic valve stenosis with coronary artery disease in patients over 75 years.
Methods. In a retrospective study of 12.000 cardiac catheterization procedures, patients with severe aortic valve stenosis were selected: the patients over 75 years (30 patients) were screened for presence/absence of coronary lesion forming two groups: correlations with anatomic and hemodynamic variables were made.
Results. 36.6% (11 patients) of the over-75 had significative coronary lesions; the coronary arteries involved were the anterior descendent coronary artery and the right coronary artery; no significative differences were found as to risk factors between the two groups except hypertension; the greater number of calcifications and mitral and aortic regurgitation was found in patients with coronary disease; the values of ejection fraction and cardiac index were significantly smaller in patients with coronary disease.
Conclusions. In patients over 75 the severe aortic valve stenosis is frequently associated with coronary disease and the association is greater than in younger persons; some particular features confirm the ederly patients as a class at particular risk in which coronary angiography and combined bypass graft and valve replacement are of primary importance for the outcomes.