Outcome of Preoperative Valve Replacement Coronary Angiography at Assiut University Hospitals

Background and Aim of the Work: Cardiac valvular affection secondary to rheumatic fever is still prevalent in our developing country. A subset of these patients will eventually undergo cardiac surgery and valve replacement. According to the guidelines, pre-operative coronary angiography is indicated in a group of them. However, the yield of this invasive procedure is low. Many publications discussed the prevalence of coronary artery disease among patients with valvular affection, most of them were having degenerative etiology. We studied the issue in a population with rheumatic valve affection. Moreover, we tried to define some parameter that could be associated with positive results of coronary Patients and Methods: 300 patients with rheumatic valve affection indicated for valve replacement surgery were enrolled in our study. Careful history taking, thorough clinical examination, ECG and echocardiography were done for all the study population. All the study population underwent coronary angiography and the results were reported.Results: The prevalence of coronary artery disease among the study population was 11%. Old age, male gender, history of coronary artery disease, family history of ischaemic heart disease, aortic stenosis and presence of left ventricular wall motion abnormalities were found to associated with coronaryConclusions: Routine preoperative coronary angiography is mandatory in order to identify subset of patient who need coronary revascularization in addition to valve replacement. Some parameters that could favorably predict the presence of coronary artery lesion include old age, history of coronary artery disease, aortic stenosis and presence of regional left ventricular wall motion abnormalities.