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KMID : 0882420120830010075
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Korean Journal of Medicine
2012 Volume.83 No. 1 p.75 ~ p.82
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Prevalence of Significant Coronary Arterial Disease in Adult Patients who Underwent Valvular Surgery in Korea
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Choi Uhng-Lim
Lee Sun-Hwa
Park Jae-Hyeong
Seong Seok-Woo
Kim Jun-Hyung
Lee Jae-Hwan
Choi Si-Wan
Jeong Jin-Ok
Seong In-Whan
Rhee Kyoung-Suk
Chae Jei-Keon
Kim Won-Ho
Ko Jae-Ki
Na Myung-Hoon
Lim Seung-Pyung
Kim Kyung-Hwa
Choi Jong-Bum
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Abstract
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Background/Aims: The identification of significant coronary arterial disease (CAD) is important to reduce perioperative ischemic insult and the possibility of repeated open-chest surgery in patients scheduled to undergo valvular surgery. However, there are no published data on the incidence of significant CAD in these patients. Thus, we examined the prevalence of significant CAD in patients scheduled to undergo valvular surgery.
Methods: From January 2005 to June 2011, all consecutive adult patients diagnosed with significant valvular disease and scheduled for an elective open valvular operation were retrospectively investigated at Chungnam National University Hospital and Chonbuk National University Hospital. Patients who underwent emergent valvular operations due to acute aortic dissection or trauma and concomitant valvular operations at the time of coronary artery bypass graft (CABG) surgery were excluded.
Results: During the study period, a total of 431 patients (58 ± 13 years old, 204 males) were included. The distributions of mitral (241 patients) and aortic valvular disease (230 patients) were similar. Coronary angiography was performed in 297 patients (68.9%). Of these, 36 (12.1%) showed significant CAD and 32 underwent concomitant CABG operations. Based on a multivariate analysis, the presence of CAD was significantly associated with old age (≥ 65 years old) [odds ratio (OR) = 3.081, 95% confidence interval (CI) = 1.372-6.921, p = 0.006], more cardiovascular risk factors (≥ 3) (OR = 3.002, 95% CI = 1.386-6.503, p = 0.005), and the presence of aortic stenosis (OR = 2.763, 95% CI = 1.269-6.013, p = 0.010).
Conclusions: The incidence of significant CAD was 12.1% in adult patients who underwent valvular operations in Korea. CAD was more common in patients with old age, aortic stenosis, and multiple cardiovascular risk factors.
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KEYWORD
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Coronary angiography, Coronary artery disease, Heart valve disease
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