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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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The safety of concomitant transcatheter aortic valve replacement and percutaneous coronary intervention: A systematic

Yong Yang1, Fang-Yang Huang, Bao-Tao Huang

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Medicine
|January 10, 2018
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) patients with coronary artery disease (CAD) show similar short-term outcomes whether percutaneous coronary intervention (PCI) is performed concomitantly or staged. This systematic review compared these approaches for TAVR patients with CAD.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Surgery

Background:

  • Transcatheter aortic valve replacement (TAVR) is increasingly used for severe aortic valve stenosis.
  • Significant coronary artery disease (CAD) affects 40-75% of TAVR patients.
  • Optimal timing for treating concomitant CAD during TAVR remains debated.

Purpose of the Study:

  • To compare short-term outcomes of concomitant percutaneous coronary intervention (PCI) and TAVR versus staged PCI and TAVR.
  • To evaluate the safety and efficacy of different revascularization strategies in TAVR patients with CAD.

Main Methods:

  • Systematic review of observational studies comparing concomitant PCI-TAVR with staged PCI-TAVR.
  • Search of the OVID database for relevant studies.
  • Random effects model used to calculate pooled odds ratios (OR) and 95% confidence intervals.

Main Results:

  • Analysis included 4 studies with 209 patients.
  • No significant differences in 30-day mortality (OR: 1.47; P=.51).
  • Similar rates of renal failure (OR: 3.22; P=.17), myocardial infarction (OR: 1.44; P=.77), major bleeding (OR: 0.45; P=.27), and stroke (OR: 3.41; P=.44).

Conclusions:

  • Current data do not demonstrate significant short-term outcome differences between concomitant and staged PCI in TAVR patients.
  • Further research may be needed to clarify optimal treatment strategies for TAVR patients with CAD.
Abstract

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