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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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The value of percutaneous coronary intervention in aortic valve stenosis with coronary artery disease

Ronny Alcalai1, Nicola Viola, Morris Mosseri

  • 1Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

The American Journal of Medicine
|February 6, 2007
PubMed

Insights

Percutaneous coronary intervention (PCI) is a safe treatment for coronary artery disease (CAD) in patients with severe aortic stenosis (AS), offering symptom relief and good outcomes for select individuals.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Valvular Heart Disease

Background:

  • Severe symptomatic aortic stenosis (AS) typically requires aortic valve replacement (AVR).
  • Coronary artery disease (CAD) frequently coexists with AS, complicating symptom attribution and treatment planning.
  • Percutaneous coronary intervention (PCI) may defer or replace surgical intervention in some patients.

Purpose of the Study:

  • To assess the feasibility and outcomes of PCI for CAD in patients with severe AS.
  • To identify patient subgroups most likely to benefit from PCI in this complex scenario.

Main Methods:

  • Retrospective analysis of 38 patients with severe AS undergoing PCI for CAD (1989-2004).
  • Inclusion of demographic, clinical, angiographic, and echocardiographic data.
  • Evaluation of PCI complications, symptom improvement, AVR, and mortality during follow-up.

Main Results:

  • The study group averaged 71 years old with a mean aortic valve area of 0.84 cm².
  • PCI was chosen due to patient preference, high surgical risk, or cardiologist recommendation.
  • 92.1% of patients reported symptomatic improvement with no major PCI complications; good functional class and single-vessel disease predicted better long-term survival.

Conclusions:

  • PCI is a safe and effective option for managing CAD in patients with severe AS.
  • Symptomatic relief is common, and good long-term outcomes are achievable in carefully selected patients.
  • PCI should be considered for patients with mild CAD, good functional class, or high surgical risk.
Abstract

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