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Updated: Dec 1, 2025
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Aortic valve replacement plus revascularization: The battle of surgical versus transcatheter approach still rages
Giuseppe Tarantini1, Chiara Fraccaro1
1Department of Cardiac, Thoracic, Vascular Science and Public Health, University of Padova, Padova, Italy.
Insights
Current guidelines recommend revascularizing coronary artery disease (CAD) in patients undergoing aortic valve replacement. Initial data suggest similar outcomes for percutaneous transcatheter versus surgical approaches in severe aortic stenosis and CAD.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Current guidelines recommend concurrent coronary artery revascularization for patients undergoing aortic valve replacement (AVR) with significant coronary artery stenosis (≥70% diameter stenosis, ≥50% for left main).
- This recommendation applies to both surgical AVR and transcatheter aortic valve replacement (TAVR).
Abstract:
The current guidelines for primary aortic valve disease suggest, with different class of recommendation, concomitant coronary artery revascularization in all candidates to aortic valve replacement with angiographic evidence of significant coronary artery diameter stenosis (≥70%, ≥50% for left main stenosis) both for surgical or transcatheter approach. Initial (non-patient-level) pooled data analyses suggest that a percutaneous transcatheter approach confers similar outcomes compared to a surgical approach in patients with severe AS and CAD. Further scientific evidences from RCTs are warranted to clarify the prognostic impact of CAD on TAVR candidates and to identify the most appropriate revascularization strategy.
