ABSTRACT
Patients with aortic stenosis and coronary artery disease have the same pathophysiology, share common risk factors and are of advancing age. The value of non-invasive electrocardiogram-stress testing to detect concomitant coronary artery disease is limited owing to the presence of left ventricular hypertrophy and left bundle branch block in patients with valvular disease. Patients with history of coronary artery bypass graft (CABG), who undergo redo cardiac surgery, have a higher risk for complications than patients undergoing their first CABG. The limited temporal resolution of 16- and 64-slice computed tomography (CT) scanners warrants the use of betablockers or benzodiazepines to reduce heart rates. Dual-source CT scanners having an increased temporal resolution of 83 ms, may allow high-quality scanning with fast heart rates. The diagnostic accuracy of 64-slice CT scanners is clinically reliable for ruling out the presence of significant coronary lesions in patients undergoing elective valve surgery, and CT coronary angiography implementation as a gatekeeper in these patients might be indicated.
