1. Prevalence and clinical impact of left coronary dominance in patients with aortic stenosis.
- Author
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Desch S, Harzendorf C, de Waha S, Eitel I, Mohr FW, Schuler G, and Thiele H
- Subjects
- Age Factors, Aged, Aged, 80 and over, Aortic Valve abnormalities, Aortic Valve surgery, Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery, Case-Control Studies, Chi-Square Distribution, Coronary Vessels surgery, Disease Progression, Female, Functional Laterality, Germany, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation mortality, Hospital Mortality, Humans, Linear Models, Male, Middle Aged, Myocardial Infarction etiology, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Aortic Valve physiopathology, Aortic Valve Stenosis physiopathology, Coronary Circulation, Coronary Vessels physiopathology
- Abstract
Background and Aim of the Study: Left coronary dominance may be more prevalent in patients with valvular aortic stenosis (AS). A cohort study was conducted to: (i) determine the prevalence of coronary left dominance in patients with AS; (ii) assess if a possible higher prevalence of left dominance is confined to patients with bicuspid aortic valve; (iii) examine if left dominance is a risk factor for the progression of AS, independent of established risk factors; and (iv) assess in-hospital clinical outcome following valve replacement according to the coronary dominance pattern., Methods: The prevalence of left coronary dominance was analyzed in 721 patients with severe isolated AS, and compared to a control cohort of 6,990 patients without AS. The clinical data and short-term outcome following valve replacement were assessed according to the coronary dominance pattern., Results: Left coronary dominance was significantly more prevalent in patients with AS compared to those without AS (13.7% versus 10.2%, p = 0.003), and a pattern of right coronary dominance was less frequent in patients with AS (66.9% versus 71.6%, p = 0.008), irrespective of the presence of a bicuspid or tricuspid valve. Left coronary dominance was not an independent predictor of younger age at the time of valve replacement. There were no differences for in-hospital mortality and rates of myocardial infarction between coronary dominance types., Conclusion: Although left coronary dominance is more prevalent in patients with AS, it is not a risk factor for disease progression, and is not associated with short-term adverse outcome following valve replacement.
- Published
- 2011