Aortic valve surgery following previous coronary artery bypass grafting: Impact of calcification and leaflet movement

We reviewed the reports of 27 patients who had an aortic valve replacement after previous coronary artery bypass grafting. The aortic valve disease – mainly aortic stenosis – showed a rapid rate of progression. In the time interval between coronary artery bypass grafting and aortic valve replacement...

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Bibliographic Details
Published in:International journal of cardiology 1998-04, Vol.64 (2), p.125-130
Main Authors: Eitz, Thomas, Kleikamp, Georg, Minami, Kazutomo, Gleichmann, Ulrich, Körfer, Reiner
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic Valve - diagnostic imaging
Aortic Valve - surgery
Aortic valve replacement
Aortic valve stenosis
Aortic Valve Stenosis - classification
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - surgery
Biological and medical sciences
Calcinosis - complications
Calcinosis - surgery
Coronary Artery Bypass
Coronary artery bypass grafting
Coronary Disease - complications
Coronary Disease - surgery
Disease Progression
Heart Valve Diseases - complications
Heart Valve Diseases - surgery
Heart Valve Prosthesis Implantation
Humans
Ischaemic heart disease
Medical sciences
Middle Aged
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Ultrasonography
Valve calcification
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Summary:We reviewed the reports of 27 patients who had an aortic valve replacement after previous coronary artery bypass grafting. The aortic valve disease – mainly aortic stenosis – showed a rapid rate of progression. In the time interval between coronary artery bypass grafting and aortic valve replacement of 4.6±2.2 years the peak-to-peak pressure gradient of the aortic valve rose from 20.2±14.3 to 63.0±22.7 mmHg. As there is a great interest to identify the patients with a high risk of a rapid progression because of a high mortality of an aortic valve replacement as the second cardiac operation following a coronary artery bypass grafting we also reviewed the cardiac catheterisation films and found a high incidence of calcification and impaired aortic valve motion (81.5% of the patients had already calcified aortic valves and 81.5% had a impaired valve motion) at the time of coronary artery bypass grafting. We concluded that if a patient has to be operated for coronary artery disease an aortic valve replacement should be considered not only according to hemodynamic criteria but also when the aortic valve is calcified or its leaflets' motion is impaired.
ISSN:0167-5273
1874-1754
DOI:10.1016/S0167-5273(98)00018-7