The Prognostic Value of Calcification and Impaired Valve Motion in Combined Aortic Stenosis and Coronary Artery Disease
Thomas Eitz MD, Georg Kleikamp MD, Kazutomo Minami MD, Reiner Körfer MD

Between 1990 and 1999, 47 patients underwent aortic valve replacement (AVR) after previous coronary artery bypass grafting (CABG). Aortic valve disease, mainly aortic stenosis, showed a rapid rate of progression. During a time interval between CABG and AVR of 5.9 ± 2.9 years, the mean peak-to-peak pressure gradient across the aortic valve rose from 16.1 ± 13.8 to 61.4 ± 23.9 mmHg. In retrospect, a high incidence of calcification (66.0%) and impaired valve motion (72.3%) was found in patients at the time of CABG, which was carried out at a mean of 9.2 ± 0.8 years before AVR. In patients with coronary artery disease and concomitant aortic stenosis, AVR should be considered not only on the basis of hemodynamic criteria but also with regard to calcification of the aortic valve and its leaflet motion.