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Updated: Oct 18, 2025

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

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Role of coronary angiogram before transcatheter aortic valve implantation

Benjamin Beska1, Divya Manoharan1, Ashfaq Mohammed1

  • 1Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, United Kingdom.

World Journal of Cardiology
|September 30, 2021
PubMed

Insights

A selective approach to coronary angiography before transcatheter aortic valve implantation (TAVI) is safe and feasible. This strategy challenges the routine use of coronary angiography in TAVI patients, showing comparable outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary artery disease frequently coexists with severe aortic stenosis requiring transcatheter aortic valve implantation (TAVI).
  • Previous research questioned the benefit of routine pre-TAVI coronary revascularization, impacting the utility of routine coronary angiography (CA).

Purpose of the Study:

  • To evaluate the safety and feasibility of a selective strategy for performing coronary angiography (CA) prior to transcatheter aortic valve implantation (TAVI).

Main Methods:

  • Retrospective, single-center analysis of 348 patients undergoing TAVI.
  • Implementation of a selective CA approach based on individual patient clinical needs.
  • Comparison of clinical outcomes between patients who underwent CA and those who did not.

Main Results:

  • The primary composite endpoint (all-cause mortality, myocardial infarction, repeat CA, heart failure re-admission) was similar between groups (22.6% vs. 22.2%).
  • Patients undergoing CA had fewer heart failure readmissions but more repeat CA and myocardial infarctions.
  • Flow-limiting lesions in CA patients did not impact the primary endpoint, except for an increased rate of repeat CA.

Conclusions:

  • Selective coronary angiography is a safe and feasible strategy in the TAVI population.
  • The routine use of coronary angiography before TAVI warrants re-evaluation in future randomized controlled trials.
Abstract

Keywords:
AngiogramCoronary angiogramRevascularisationTranscatheter aortic valve implantation

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