Incidence and implications of coronary artery disease in patients undergoing valvular heart surgery: The Indian scenario.
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Date
2013-04
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Abstract
Aims and Objectives: We evaluated the incidence and implications of coronary artery disease (CAD) in patients above 40 years presenting for valve surgery. Materials and Methods: Between January 2009 and December 2010, coronary angiography (CAG) was performed in all such patients ( n = 140). Results: Coronaries were normal in 119 (Group I), and diseased in 21 (Group II). In Group II, 11 patients were < 50 years, 3 were between 51 and 60 years and 7 were > 61 years. In 8 of these, only valve replacement was performed. Coronary artery bypass grafting (CABG) and aortic valve replacement was performed in 10, CABG and mitral valve replacement in 2 and CABG with mitral and aortic valve replacement in one. The number of vessels grafted in these 13 patients was 1.54 ± 0.66. Hypertension and diabetes were significant ( P < 0.05) in this group. The mortality was significant in Group II (11 vs. 6, P < 0.05). Six patients died in Group II, 5 had severe aortic stenosis and severe left ventricular hypertrophy; the sixth patient had severe mitral stenosis and was in CHF. The predominant cause of death was congestive heart failure (CHF). Conclusions: Fifteen percentage of these patients had CAD. CAG should be performed routinely in these patients while presenting for valve surgery. Combined CABG and valve replacement carries high mortality (28.5%), especially in patients with aortic stenosis. The study suggests that the cardio-protective measures should be applied more rigorously in this subset of patients.
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Keywords
Cardiac surgery, Coronary artery bypass grafting, Coronary artery disease, Valve surgery
Citation
Tempe Deepak K, Virmani Sanjula, Gupta Rupak, Datt Vishnu, Joshi Chandrashekhar, Dhingra Aastha, Dutta Rahul, Minhas Harpreet Singh. Incidence and implications of coronary artery disease in patients undergoing valvular heart surgery: The Indian scenario. Annals of Cardiac Anaesthesia. 2013 Apr; 16(2): 86-91.