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Coronary artery disease and transcatheter aortic valve replacement: current treatment paradigms

Jean-Michel Paradis1, Benoit Labbé, Josep Rodés-Cabau

  • 1aQuebec Heart and Lung Institute, Quebec, Quebec, Canada bCardiovascular Research Foundation, New York, New York, USA.

Coronary Artery Disease
|January 21, 2015
PubMed

Insights

Aortic stenosis and coronary artery disease often coexist in elderly patients. This review explores management strategies for patients with both conditions, especially those undergoing transcatheter aortic valve replacement.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Valvular Heart Disease

Background:

  • Aortic stenosis is the most prevalent valvular heart disease in the elderly.
  • Coronary artery disease frequently coexists with aortic stenosis.
  • Transcatheter aortic valve replacement offers an alternative to surgery for high-risk patients.

Purpose of the Study:

  • To provide a comprehensive overview of managing coronary artery disease in patients with aortic stenosis.
  • To discuss treatment approaches for patients with concomitant aortic stenosis and coronary artery disease.
  • To address the controversial aspects of coronary artery disease management in the context of transcatheter aortic valve replacement.

Main Methods:

  • Literature review of existing studies on aortic stenosis and coronary artery disease management.
  • Analysis of treatment options for patients with combined valvular and coronary disease.
  • Synthesis of current evidence regarding transcatheter aortic valve replacement in patients with coronary artery disease.

Main Results:

  • Conflicting results exist in the literature regarding the optimal management of coronary artery disease in patients undergoing transcatheter aortic valve replacement.
  • Surgical aortic valve replacement has been the traditional treatment for aortic stenosis.
  • Transcatheter aortic valve replacement has expanded treatment options for high-risk individuals.

Conclusions:

  • The management of coronary artery disease in patients with aortic stenosis, particularly those undergoing transcatheter aortic valve replacement, requires careful consideration.
  • Further research is needed to resolve controversies in managing concomitant coronary artery disease and aortic stenosis.
  • This review proposes treatment approaches for this complex patient population.

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