Related Experiment Video

Updated: Aug 31, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

1.7K

The Effect of Coronary Lesion Complexity and Preprocedural Revascularization on 5-Year Outcomes After TAVR

Lennert Minten1, Pauline Wissels2, Keir McCutcheon2

  • 1Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Cardiovascular Medicine, University Hospital Leuven, Leuven, Belgium.

JACC. Cardiovascular Interventions
|August 18, 2022
PubMed

Insights

Coronary artery disease (CAD) complicates transcatheter aortic valve replacement (TAVR) outcomes. While CAD presence and complexity worsen survival, angiography-guided percutaneous coronary intervention (PCI) offers no benefit, suggesting a need for new strategies.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Aortic stenosis and coronary artery disease (CAD) frequently coexist.
  • Management of concurrent CAD in patients undergoing transcatheter aortic valve replacement (TAVR) is debated.

Purpose of the Study:

  • To assess the association of CAD presence, complexity, and angiography-guided percutaneous coronary intervention (PCI) with outcomes after TAVR.

Main Methods:

  • Prospective observational study of 604 patients undergoing TAVR.
  • Calculation of baseline and residual SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) scores (SS).
  • Multivariate analysis to evaluate the impact of CAD complexity and PCI on 5-year outcomes.

Main Results:

  • CAD presence and complexity significantly correlated with worse 5-year survival and increased cardiovascular mortality.
  • Noncomplex CAD (SS 1-22) independently predicted increased all-cause mortality (HR: 1.43; P=0.046).
  • Complex CAD (SS >22) significantly increased cardiovascular mortality (HR: 1.84; P=0.041), while angiography-guided PCI did not improve outcomes.

Conclusions:

  • CAD presence and anatomical complexity are linked to poorer 5-year outcomes in TAVR patients.
  • Angiography-guided PCI did not enhance outcomes.
  • Further research into physiology-guided PCI is warranted for optimal management.
Abstract

Keywords:
coronary artery diseasepercutaneous coronary interventionsevere aortic stenosistranscatheter aortic valve replacement

More Related Videos

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

3.6K
Author Spotlight: Enhancing Coronary Artery Revascularization05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

832

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
21
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
24
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
28
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
1.4K
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
39
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
27