Aortic Stenosis in Patients Undergoing Coronary Artery Bypass Grafting or Ascending Aorta Surgery

When a patient with aortic stenosis — whether severe or moderate — is already scheduled for coronary artery bypass grafting (CABG) or surgical intervention on the ascending aorta, the open chest setting creates a time-sensitive decision point regarding the aortic valve itself.

Clinical scenario This protocol addresses two distinct but related presentations:

Severe aortic stenosis in a patient undergoing CABG or ascending aorta surgery
Moderate aortic stenosis in a patient undergoing CABG or ascending aorta surgery

In both cases, the concurrence of planned cardiac surgery raises the question of simultaneous valve management — and the severity of stenosis guides the strength of the recommendation.

Treatment approach The recommended strategy involves a surgical intervention on the aortic valve performed concomitantly with the primary planned procedure (CABG or ascending aorta repair) — addressing the valve at the same operative sitting rather than deferring it.

The specific indications, eligibility criteria, and full procedural guidance are outlined in the complete protocol →

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehaf194

SAVR is recommended in symptomatic and asymptomatic patients with severe AS undergoing CABG or surgical intervention on the ascending aorta.

SAVR should be considered in symptomatic and asymptomatic patients with moderate AS undergoing CABG or surgical intervention on the ascending aorta.

Surgical intervention for moderate AS should only be performed in patients undergoing CABG, surgery of the ascending aorta or other valve disease.

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