[Retrospective study of the role of systematic coronarography in patients with heart valve diseases]. / Etude rétrospective du rôle de la coronarographie systématique chez les patients valvulaires.

The aim of this study was to assess retrospectively the valve of routine coronary angiography in the investigation of patients with valvular heart disease. Between 1978 and 1981, 598 patients over 40 years old underwent left heart catheterisation with routine coronary angiography. In the group with a medical history of angina or infarction (N = 149), there were 49 cases (33%) of severe coronary artery disease (greater than or equal to 70%) and 17 cases of moderate coronary artery disease (11%); of the 49 patients with severe lesions, 2 died after catheterisation, 8 were considered to have too high an operative risk because of their coronary disease and 19 were operated. Valve replacement was associated with a procedure for myocardial revascularisation in 15 cases. In the group without angina (N = 449), severe coronary lesions were much less common (3.6%) and only 5.1% had moderate coronary disease. Severe coronary lesions were found more frequently in certain sub-groups: Stage IV dyspnoea (9%), patients over 65 years of age (11.5%), and coronary calcification (24%). Of the 39 patients without angina and over 50% narrowing on coronary angiography, 17 underwent isolated valve surgery, and 9 underwent combined valvular and coronary surgery (2% of catheterised patients without angina; 3.5% of patients operated without angina. These results show that routine coronary angiography is fully justified in patients with valvular heart disease and a history of angina as vital information is obtained in a high proportion of cases.(ABSTRACT TRUNCATED AT 250 WORDS)