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Coronary angioplasty after self-expandable transcatheter aortic valve implantation
Gabriel Greenberg1, Ran Kornowski
1Rabin Medical Center, Cardiology, Jabutinski Street 39, Petah-Tikva 49100, Israel.
Insights
Percutaneous coronary intervention (PCI) after transcatheter aortic valve implantation (TAVI) is feasible and safe. Careful planning is essential due to the prosthetic valve
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
Background:
- Aortic stenosis and coronary artery disease frequently coexist due to shared risk factors.
- Increased life expectancy after transcatheter aortic valve implantation (TAVI) is leading to more patients requiring subsequent percutaneous coronary intervention (PCI).
Observation:
- This report details two cases of successful PCI performed after CoreValve transcatheter aortic valve implantation.
- The procedures highlight the importance of understanding the spatial relationship between the prosthetic valve and coronary arteries.
Findings:
- PCI following TAVI is a technically feasible and safe intervention.
- Successful PCI requires meticulous pre-procedural planning and a thorough understanding of the device's three-dimensional anatomy.
Implications:
- These findings suggest that PCI can be safely performed in patients with TAVI.
- Further research and careful case selection are warranted to optimize outcomes for PCI post-TAVI.
Abstract:
Aortic stenosis and coronary artery disease share comorbidities/risk factors; thus, it is not surprising they occur concomitantly. With increased life expectancy of patients who undergo transcatheter aortic valve implantation (TAVI), the rate of post-TAVI percutaneous coronary intervention (PCI) is expected to rise. In the current report, we present two cases using PCI following CoreValve (Medtronic) implantation. Our cases indicated that the procedure is feasible and safe, but requires careful planning and understanding of the three-dimensional geometry of the prosthetic valve and its relation to the coronary ostia.