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Dynamic Changes in Coronary Flow Pattern During Transcatheter Aortic Valve Replacement in Severe Aortic Stenosis
Wataru Suzuki1, Yusuke Nakano1, Hirohiko Ando1
1Department of Cardiology, Aichi Medical University, Nagakute, Japan.
JACC. Case Reports
|October 25, 2021
Summary
Severe aortic stenosis impairs coronary flow reserve, even without coronary artery blockages. Transcatheter aortic valve replacement dynamically alters coronary flow patterns, as observed via transesophageal echocardiography.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Echocardiography
Background:
- Severe aortic stenosis (AS) can reduce coronary flow reserve (CFR) independent of coronary artery disease (CAD).
- Understanding hemodynamic changes in AS is crucial for managing patients undergoing aortic valve interventions.
Purpose of the Study:
- To investigate the dynamic changes in coronary flow patterns during transcatheter aortic valve replacement (TAVR) in patients with severe AS.
- To assess the impact of TAVR on coronary flow reserve in the absence of significant coronary stenosis.
Main Methods:
- Periprocedural transesophageal echocardiography (TEE) was utilized to visualize and assess coronary flow dynamics.
- Coronary flow reserve was evaluated in patients with severe AS before and after TAVR.
Main Results:
- Coronary flow reserve was found to be decreased in patients with severe AS, even without obstructive coronary artery disease.
- Transcatheter aortic valve replacement demonstrated observable dynamic changes in coronary flow patterns.
Conclusions:
- Severe aortic stenosis adversely affects coronary hemodynamics.
- TEE is a valuable tool for monitoring dynamic changes in coronary flow during TAVR procedures.
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