The Epidemiology And Clinical Analysis Of Heart Valve Diseases Combining With Coronary Artery Diseases

[Objective]:This study aims to analyse the prevalence of heart valve diseases combining with coronary artery diseases and to determine indications for coronary angiography in these patients by collecting all such cases in our department. These all help to find out indications for CABG and valve sugery simultaneously and perioperative issues ,controversies. [Method] Coronary angiography was performed before valve surgery for 868 patients at the Changhai Hospital in Shanghai from January 2000 to June 2006 and prospectively analyse 104 patients performed valve surgery and CABG simultaneously. [Result] 1,Male patients with valve diseases had a higher incidence of CAD than female patients.When preparing to do coronary angiography before valve surgery ,we should pay attention to whether this patient had some risk factors of CAD in order to avoid omitting CAD. Patients with all kinds of valve diseases had similar incidence of CAD. 2,94 patients were discharged and had a significant improvement in cardiac function, while 10 patients died in the early postoperative period. [Conclusion] 1,Male paients with heart valve diseases older than 50 have a high incidence of CAD. So these paients should be performed coronary angiography. Paients under 50 do not evitabably be performed coronary angiography as routine. But if they have some risk factors of CAD such as hypertention,diabetes militus,obesity,history of cigarette smoking,family history and so on,they should have coronary angiography peformed to rule out the possibility of CAD. 2,In the case of patients with heart valve diseases combining with coronary artery diseases,we should assess cardiac function before surgery and predict the effect of alteration of preload and overload on cardiac function before surgery.Then we make sure to lower surgery motality and complication incidence according to blood dynamic results and pathophysiological bases after surgery.