The influence of coronary artery disease and bypass grafting on early and late survival after valve replacement for aortic stenosis

The influence of coronary artery disease and bypass grafting on survival after valve replacement for aortic stenosis was analyzed. Left ventricular failure and a high coronary artery disease score were independent determinants of early mortality. Despite more severe coronary artery disease, bypass grafting reduced early mortality contrasting with a high early mortality rate for unbypassed coronary artery disease. Coronary artery disease increased the late mortality rate, which was not modified by bypass grafting. Undiagnosed and unbypassed coronary artery disease probably increased both early and late mortality. Coronary angiography should be performed in all adult patients with aortic stenosis, and those with significant coronary artery disease should undergo bypass grafting concomitant with valve replacement