The evoluatin of frequency of coronary artery disease in patients that have valvuler operation

AIM: In this study wree investigated retrospectively the frequency of coronary heart disease in patients who had been operated due to severe valvular heart disease. In subgroup we also investigated if there is a difference the frequency of coronary artery disease, according to the type of valve pathology. METHOD: In this study we included a total of 104 patients including 56 women (53.8% ), 48 men(46.2%) who have had heart valve surgery. We included patients who have had surgery only a single valve . We examined patients into four groups who have had prosthetic valve replacement due to severe mitral stenosis (MS), severe mitral regurgitation (MR), severe aortic regurtgitation (AR) , severe aortic stenosis (AS). If there is no plaque, irregularity, ectasia and slow flow in all epicardial coronary arteries (including side branches) were considered normal , If at least one of the above were exist, those were considered as coronary artery disease. Significant coronary artery disease defined as more than 50 % stenosis at least in one coronary artery, non significant coronary artery disease defined as less than 50% stenosis at least in one coronary artery. We used Gensini score in order to assess the severity of coronary artery disease. Patients with severe mitral stenosis who underwent MVR and patients with aortic stenosis who underwent AVR compared between each other in terms of the significance of coronary artery disease. Also patients with severe mitral regurgitation who undewent MVR and patients with severe aortic regurgitation compared in terms of coronary artery disaese. RESULTS: 32 patients who underwent MVR due to mitral stenosis (30.8%), 36 (34.6%) patients who underwent AVR due to severe aortic stenosis, 28 (26.9%) patients who underwent MVR due to severe mitral regujitation, 8 (7.7%) patients who underwent AVR due to severe aortic regurjitation were assesed. Coronary artery disease was detected in 40.6% patients with mitral stenosis and 60.7% patients with aortic stenosis. Also coronary artery disease was detected in 52.6% patients with severe mitral regurjitation, 50% patients with severe aortic regurjitation DISCUSSION: There was no signficiant difference between MS and AS groups in terms of coronary artery disease frequency. However, AS group had significantly higher Gensini score compare to MS group (4,18±10,94 karşı 15,21±32,93, p=0.021). There was no signficiant difference between MR and AR groups in terms of coronary artery disease frequency. CAD disease severity (Gensini score) were found smilar in MS, AR, MR. groups In a multivariate analyses in terms of CAD predictors, the most significant risk factor was DM following smoking and LDL.