Increased rate of left predominance associated with adult valvular aortic stenosis

The anatomy of the coronary arteries was outlined angiographically in 2,190 adult patients in order to determine the proportion of left predominance. Of 253 patients with valvular aortic stenosis 14.3 per cent were found to have left predominance, while the frequency of left predominance in the rest of the patients (1937) was 8.5 per cent. Furthermore, this rate increases with the severity (gradient greater than 50 mmHg) of the aortic stenosis in the absence of aortic valve incompetence. These findings support the current concept of a relationship between adult aortic stenosis and congenital valvular malformation.