[Aortic stenosis in adults: contribution of catheterization to the study of associated lesions. Apropos of 137 cases]

The results of cardiac catheterisation in 137 cases of pure adult aortic stenosis considered to be isolated after non-invasive investigation (clinical examination, carotid pulse tracing, echocardiogramme) are reported. The authors analyse the reliability and risks of this examination to which they attribute a triple objective; evaluation of the severity of the AS, evaluation of LV and/or mitral valve dysfunction and the assessment of the coronary circulation in patients with angina or in all patients over 54 years of age or with coronary calcifications. The aortic valve was crossed in 89,8 p. 100 of patients. Coronary angiography was attempted in 128 cases (93,4 p. 100) and was successful in 110 cases (85,9 p. 100). The investigation was complicated by one death (0,73 p. 100) and one femoral artery thrombosis, and was complete in only 74 p. 100 of cases. The results showed the aortic stenosis to be isolated in only 84 cases (61,3 p. 100). In the other 53 cases (38,7 p. 100) there was unrecognised associated pathology: mitral valve disease was diagnosed in 14 cases (12,3 p. 100); significant coronary artery disease (greater than 50 p. 100 narrowing) was observed in 34 of the 110 patients in whom coronary angiography was successful (30,9 p. 100). In the last 5 cases, catheterisation showed: two ASDs, one partial abnormal pulmonary venous drainage, one fusiform aneurysm of the aortic isthmus, one abnormal origin of the left anterior descending artery in the right coronary sinus with a pre-pulmonary trajectory. The authors discuss the value of the various methods of preoperative assessment of AS. The relative reliability of the different non-invasive techniques is compared.(ABSTRACT TRUNCATED AT 250 WORDS)