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Subjects and methodsCardiac catheterization laboratory records were reviewed to identify all patients who had undergone both diagnostic catheterization for evaluation of aortic stenosis and coronary arteriography from the date it became routine policy in our hospitals to perform the latter procedure on all cases of left ventricular outflow obstruction before surgery. Since we were interested in examining only those patients with unequivocally severe aortic stenosis who were in an age range which could make concomitant coronary atherosclerosis a reasonable possibility, the following criteria were established for inclusion in the study: i) A systolic aortic valvular gradient of more than 5o mmHg (6.7 kPa) or calculated aortic valve area of less than 0.75 cm2, and 2) age over 35 years.Several patients included in the study had associated trivial aortic regurgitation or mitral valve disease, but in all cases aortic stenosis was clearly the dominant lesion. Aortic valve areas were calculated by the hydraulic formula of Gorlin and Gorlin (i95i), where applicable. Four patients were included in whom the aortic valve could not be traversed at the time of catheterization but in whom the presence of severe aortic stenosis was confirmed at surgery.Selective coronary arteriography was performed by the Sones' or Judkin's technique. In the majority of cases, the coronary arteries were opacified in at least two views, usually the left and right anterior oblique. An occasional case was retained in which a vessel was seen in one on 28 April 2019 by guest. Protected by copyright.

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