Key result
Untreated 50-70% coronary stenosis does not increase MACE or mortality in aortic regurgitation patients.
Why the study?
The optimal management strategy for 50-70% chronic coronary artery stenosis in patients undergoing aortic valve surgery for aortic regurgitation remains controversial.
Does untreated 50-70% chronic coronary artery stenosis increase MACE or mortality in patients undergoing aortic valve surgery for aortic regurgitation compared to <50% stenosis?
Does untreated 50-70% chronic coronary artery stenosis increase MACE or mortality in patients undergoing aortic valve surgery for aortic regurgitation compared to <50% stenosis?
Answers are grounded in this paper and cite their sources.
Leaving 50-70% chronic coronary artery stenosis untreated during aortic valve surgery for aortic regurgitation does not appear to increase mid-term MACE or mortality compared to patients with <50% stenosis.
Background: The optimal management strategy for 50–70% chronic coronary artery stenosis in patients undergoing aortic valve surgery for aortic regurgitation (AR) remains controversial. This study evaluates the prognostic impact of chronic coronary obstruction severity on surgical outcomes and mid-term survival. Methods: This retrospective cohort study included 717 patients undergoing aortic valve surgery for AR, grouped by coronary stenosis into <50% (n = 641) and 50–70% (n = 76). Following 1:1 propensity score matching (72 patients per group), the primary outcome of major adverse cardiovascular events (MACE) and the secondary outcome of all-cause death were compared. Results: No intergroup differences emerged in perioperative mortality (1.32% vs. 1.56%, p = 1.000) or complication rate. With a median follow-up of 2.53 years, 50–70% coronary obstruction does not increase MACE (HR = 2.050; 95% CI 0.375–11.197; log-rank p = 0.397) and all-cause mortality (HR = 0.710; 95% CI 0.200–2.522; log-rank p = 0.595). Similar results were obtained in the competing risk regression and multivariable analyses. Conclusions: In patients with AR, 50–70% chronic coronary obstruction does not increase perioperative complications, MACE, and all-cause mortality.
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Li et al. (2026) studied this question. In aortic regurgitation patients, untreated 50–70% chronic coronary artery obstruction did not increase perioperative mortality, MACE, or all-cause death over 2.5 years.
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