RESUMO
BACKGROUND: Aortic valve replacement is an effective and safe intervention in the elderly, but to-day the prevalence of coronary artery disease in the elderly has still to be clarified. Aim of this paper is to analyze in a retrospective study the epidemiology and the hemodynamic relation of the association of severe aortic valve stenosis with coronary artery disease in patients over 75 years. METHODS: In a retrospective study of 12.000 cardiac catheterization procedures, patients with severe aortic valve stenosis were selected: the patients over 75 years (30 patients) were screened for presence/absence of coronary lesion forming two groups: correlations with anatomic and hemodynamic variables were made. RESULTS: 36.6% (11 patients) of the over-75 had significative coronary lesions; the coronary arteries involved were the anterior descendent coronary artery and the right coronary artery; no significative differences were found as to risk factors between the two groups except hypertension; the greater number of calcifications and mitral and aortic regurgitation was found in patients with coronary disease; the values of ejection fraction and cardiac index were significantly smaller in patients with coronary disease. CONCLUSIONS: In patients over 75 the severe aortic valve stenosis is frequently associated with coronary disease and the association is greater than in younger persons; some particular features confirm the elderly patients as a class at particular risk in which coronary angiography and combined bypass graft and valve replacement are of primary importance for the outcomes.
