Abstract
The case notes, cardiac catheterisation data, and coronary arteriograms of 239 patients investigated for valvular heart disease during a five year period were reviewed. Angina present in 13 of 95 patients with isolated mitral valve disease, 43 of 90 patients with isolated aortic valve disease, and 18 of 54 patients with combined mitral and aortic valve disease. Significant coronary artery disease was present in 85 per cent of patients with mitral valve disease and angina, but in only 33 per cent of patients with aortic valve disease and angina. Patients with no chest pain still had a high incidence of coronary artery disease, significant coronary obstruction being present in 22 per cent with mitral valve disease, 22 per cent with aortic valve disease, and 11 per cent with combine mitral and aortic valve disease. Several possible clinical markers of coronary artery disease were examined but none was found to be of practical help. There was, however, a significant inverse relation between severity of coronary artery disease and severity of valve disease in patients with aortic valve disease. Asymptomatic coronary artery disease is not uncommon in patients with valvular heart disease and if it is policy to perform coronary artery bypass grafting in such patients, routine coronary arteriography must be part of the preoperative investigation.
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- BAKER C., SOMERVILLE J. Clinical features and surgical treatment of fifty patients with severe aortic stenosis. Guys Hosp Rep. 1959;108:101–125. [PubMed] [Google Scholar]
- Basta L. L., Raines D., Najjar S., Kioschos J. M. Clinical, haemodynamic, and coronary angiographic correlates of angina pectoris in patients with severe aortic valve disease. Br Heart J. 1975 Feb;37(2):150–157. doi: 10.1136/hrt.37.2.150. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Baxter R. H., Reid J. M., McGuiness J. B., Stevenson J. G. Relation of angina to coronary artery disease in mitral and in aortic valve disease. Br Heart J. 1978 Aug;40(8):918–922. doi: 10.1136/hrt.40.8.918. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Befeler B., Kamen A. R., MacLeod C. A. Coronary artery disease and left ventricular function in mitral stenosis. Chest. 1970 May;57(5):435–439. doi: 10.1378/chest.57.5.435. [DOI] [PubMed] [Google Scholar]
- Berndt T. B., Hancock E. W., Shumway N. E., Harrison D. C. Aortic valve replacement with and without coronary artery bypass surgery. Circulation. 1974 Nov;50(5):967–971. doi: 10.1161/01.cir.50.5.967. [DOI] [PubMed] [Google Scholar]
- Bonchek L. I., Anderson R. P., Rösch J. Should coronary arteriography be performed routinely before valve replacement? Am J Cardiol. 1973 Apr;31(4):462–466. doi: 10.1016/0002-9149(73)90295-6. [DOI] [PubMed] [Google Scholar]
- Copeland J. G., Griepp R. B., Stinson E. B., Shumway N. E. Long-term follow-up after isolated aortic valve replacement. J Thorac Cardiovasc Surg. 1977 Dec;74(6):875–889. [PubMed] [Google Scholar]
- Erikssen J., Enge I., Forfang K., Storstein O. False positive diagnostic tests and coronary angiographic findings in 105 presumably healthy males. Circulation. 1976 Sep;54(3):371–376. doi: 10.1161/01.cir.54.3.371. [DOI] [PubMed] [Google Scholar]
- Fishman N. H., Youker J. E., Roe B. B. Mechanical injury to the coronary arteries during operative cannulation. Am Heart J. 1968 Jan;75(1):26–33. doi: 10.1016/0002-8703(68)90113-0. [DOI] [PubMed] [Google Scholar]
- GARDNER F. E., WHITE P. D. Coronary occlusion and myocardial infarction associated with chronic rheumatic heart disease. Ann Intern Med. 1949 Dec;31(6):1003–1009. doi: 10.7326/0003-4819-31-6-1003. [DOI] [PubMed] [Google Scholar]
- Harris C. N., Kaplan M. A., Parker D. P., Dunne E. F., Cowell H. S., Ellestad M. H. Aortic stenosis, angina, and coronary artery disease. Interrelations. Br Heart J. 1975 Jun;37(6):656–661. doi: 10.1136/hrt.37.6.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kasser I. S., Kennedy J. W. Measurement of left ventricular volumes in man by single-plane cineangiocardiography. Invest Radiol. 1969 Mar-Apr;4(2):83–90. doi: 10.1097/00004424-196904020-00005. [DOI] [PubMed] [Google Scholar]
- LEWES D. Diagnosis of aortic stenosis based on a study of 25 proved cases. Br Med J. 1951 Feb 3;1(4700):211–216. doi: 10.1136/bmj.1.4700.211. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Loop F. D., Favaloro R. G., Shirey E. K., Groves L. K., Effler D. B. Surgery for combined valvular and coronary heart disease. JAMA. 1972 Apr 17;220(3):372–376. [PubMed] [Google Scholar]
- Loop F. D., Phillips D. F., Roy M., Taylor P. C., Groves L. K., Effler D. B. Aortic valve replacement combined with myocardial revascularization. Late clinical results and survival of surgically-treated aortic valve patients with and without coronary artery disease. Circulation. 1977 Jan;55(1):169–173. doi: 10.1161/01.cir.55.1.169. [DOI] [PubMed] [Google Scholar]
- Macmanus Q., Grunkemeier G., Lambert L., Dietl C., Starr A. Aortic valve replacement and aorta-coronary bypass surgery. Results with perfusion of proximal and distal coronary arteries. J Thorac Cardiovasc Surg. 1978 Jun;75(6):865–869. [PubMed] [Google Scholar]
- Mandal A. B., Gray I. R. Significance of angina pectoris in aortic valve stenosis. Br Heart J. 1976 Aug;38(8):811–815. doi: 10.1136/hrt.38.8.811. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moraski R. E., Russell R. O., Jr, Mantle J. A., Rackley C. E. Aortic stenosis, angina pectoris, coronary artery disease. Cathet Cardiovasc Diagn. 1976;2(2):157–164. doi: 10.1002/ccd.1810020207. [DOI] [PubMed] [Google Scholar]
- Nakib A., Lillehei C. W., Edwards J. E. The degree of coronary atherosclerosis in aortic valvular disease. Arch Pathol. 1965 Nov;80(5):517–520. [PubMed] [Google Scholar]
- Richardson J. V., Kouchoukos N. T., Wright J. O., 3rd, Karp R. B. Combined aortic valve replacement and myocardial revascularization: results in 220 patients. Circulation. 1979 Jan;59(1):75–81. doi: 10.1161/01.cir.59.1.75. [DOI] [PubMed] [Google Scholar]
- Ross J. K., Monro J. L., Manners J. M., Edwards J. C., Lewis B., Hyde I., Conway N., Johnson A. M. Cardiac surgery in Wessex: review of 1000 consecutive open-heart procedures. Br Med J. 1976 Dec 18;2(6050):1485–1489. doi: 10.1136/bmj.2.6050.1485. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rossiter S. J., Hultgren H. N., Kosek J. C., Wuerflein R. D., Angell W. W. Ischemic myocardial injury with aortic valve replacement and coronary bypass. Arch Surg. 1974 Nov;109(5):652–658. doi: 10.1001/archsurg.1974.01360050046011. [DOI] [PubMed] [Google Scholar]
- Sharratt G. P., Rees P., Conway N. Myocardial infarction complicating aortic valve replacement. J Thorac Cardiovasc Surg. 1976 Jun;71(6):869–871. [PubMed] [Google Scholar]
- Swanton R. H., Brooksby I. A., Jenkins B. S., Coltart D. J., Webb-Peploe M. M., Williams B. T., Braimbridge M. V. Determinants of angina in aortic stenosis and the importance of coronary arteriography. Br Heart J. 1977 Dec;39(12):1347–1352. doi: 10.1136/hrt.39.12.1347. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tadavarthy S. M., Vlodaver Z., Edwards J. E. Coronary atherosclerosis in subjects with mitral stenosis. Circulation. 1976 Sep;54(3):519–521. doi: 10.1161/01.cir.54.3.519. [DOI] [PubMed] [Google Scholar]