Strategies for Revascularization in Patients Undergoing Heart Valve Surgery With Concomitant Coronary Artery Disease

Inclusion Criteria: * Age \> 18 years * Severe heart valve disease with indication for an elective cardiac with a St. Jude Medical Heart Valve * Concomitant significant CAD (at least one epicardial vessel with a stenosis\> 50%) * Willing and able to provide informed written consent Exclusion Criteria: * Previous CABG * Angiographic significant lesion involving left main lesion (patient is still eligible if right coronary artery is candidate for FFR measurement and surgical revascularization) * All lesions in extremely tortuous or calcified coronary vessels * Recent myocardial infarction (\< 30 days) * Cardiogenic shock or clinical instability (i.e. NYHA 4, uncontrolled arrhythmias, unexplained hypotension severe bradycardia or any other medical condition considered as a sign of instability by the assisting physician) * Severe left ventricular dysfunction (EF \< 35%) * Pregnant or are planning to become pregnant during the duration of the investigation * Chronic renal dysfunction as defined as estimated glomerular filtration rate \< 60 ml/min * Life expectancy \< 12 months * Currently participating in any other clinical investigation