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Related Concept Videos

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Aortic Regurgitation III: Medical Management

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Related Experiment Video

Updated: Jul 26, 2026

Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy
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[TAVI and coronary revascularization].

N Combaret1, M Bouchant1, P Motreff1

  • 1Service de cardiologie, centre hospitalier universitaire Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.

Annales De Cardiologie Et D'Angeiologie
|October 26, 2019
PubMed
Summary

Transcatheter aortic valve implantation (TAVI) can be complicated by coronary artery occlusion, particularly affecting the left main coronary artery. Pre-procedural imaging is crucial for identifying high-risk patients to prevent serious complications.

Keywords:
Aortic stenosisCoronarographieCoronarographyCoronaropathieCoronary artery diseaseCoronary occlusionOcclusion coronaireRétrécissement aortiqueTAVI

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Severe aortic stenosis often coexists with coronary artery disease in inoperable patients.
  • Transcatheter aortic valve implantation (TAVI) is a primary treatment for severe aortic stenosis.
  • The impact of coronary lesions on survival after TAVI remains debated.

Purpose of the Study:

  • To review the implications of coronary artery disease in patients undergoing TAVI.
  • To discuss the risks and management of coronary artery occlusion during TAVI.
  • To outline strategies for percutaneous coronary intervention (PCI) post-TAVI.

Main Methods:

  • Review of existing literature on TAVI and coronary artery disease.
  • Analysis of factors contributing to coronary artery occlusion during TAVI.
  • Discussion of imaging techniques for risk stratification.
  • Evaluation of PCI techniques following TAVI.

Main Results:

  • Coronary revascularization may benefit selected proximal lesions before or during TAVI.
  • Periprocedural coronary artery occlusion is rare but carries a poor prognosis, often involving the left main coronary artery.
  • Risk factors for occlusion include short implantation distance and small aortic sinuses.
  • Late occlusions are linked to thrombus or fibrosis.
  • PCI success rates after TAVI are often low due to procedural challenges.

Conclusions:

  • Pre-TAVI imaging is vital for identifying high-risk cases and implementing preventive measures.
  • Management strategies for coronary artery disease in TAVI patients require careful consideration.
  • Specific PCI techniques are necessary for managing coronary interventions post-TAVI.