Does coronary disease increase the hospital lethality in patients with aortic valve disease undergoing valve replacement?

Objectives: With the increase in life expectancy occurred in recent decades, a concomitant increase in the prevalence of aortic stenosis and coronary artery disease (CAD) has been noted. This study aims to evaluate the influence of CAD in patients undergoing isolated aortic valve replacement (AVR).

Methods: In the period from January 2007 to 2011, we retrospectively analyzed 94 patients undergoing isolated AVR with concomitant CAD (group I) and 314 patients undergoing isolated AVR without CAD (group II). Patients with endocarditis and/or combined intervention were excluded. The statistical study employed univariant and multivariate analysis.

Results: In hospital mortality was 4.0% in group I and 5.0% in group II. In group I significantly more patients developed renal failure (21.0% vs. 8.0%; OR: 3.13; p = 0.0) as well as acute myocardial infarction (4.0% vs. 0.3%; OR: 13.88; p = 0.019) during their hospital stay. No statistical significant difference between both groups was observed concerning the stroke rate (1.0% vs. 5.0%; OR: 0.21; p = 0.138). However patients in group I suffered significantly more often from postoperative psychotic syndromes (40.0% vs. 26.0%; OR: 1.92; p = 0.008).

Conclusions: Our results suggest that AVR is a treatment with excellent surgical results even in the presence of concomitant CAD. Despite a higher risk in patients with concomitant CAD for perioperative development of renal failure, postoperative psychotic symptoms and acute myocardial infarction, the presence of CAD has no significant influence on in hospital lethality.