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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Coronary Artery Disease and Revascularization in Patients Undergoing Transcatheter Aortic Valve Replacement

Aakash Garg1, Suleman Ilyas1, Michael Cryer2

  • 1Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.

Reviews in Cardiovascular Medicine
|July 30, 2024
PubMed

Insights

Coronary artery disease (CAD) is common in patients undergoing transcatheter aortic valve replacement (TAVR). Optimal management of CAD before and after TAVR requires further research to improve patient outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary artery disease (CAD) and aortic stenosis share common risk factors and pathophysiology.
  • CAD is prevalent in up to 50% of patients evaluated for aortic valve replacement, impacting outcomes.

Purpose of the Study:

  • To review current literature on CAD in patients undergoing transcatheter aortic valve replacement (TAVR).
  • To focus on CAD prevalence, impact on outcomes, revascularization timing, and post-TAVR coronary intervention challenges.

Main Methods:

  • Systematic literature review of studies on CAD in TAVR patients.
  • Analysis of data regarding pre-TAVR CAD evaluation and revascularization strategies.
  • Examination of outcomes and feasibility of coronary interventions after TAVR.

Main Results:

  • CAD significantly affects outcomes in TAVR patients, particularly with severe disease.
  • Optimal timing and indications for revascularization in TAVR patients remain under investigation.
  • Limited data exists on the incidence, feasibility, and outcomes of percutaneous coronary intervention (PCI) post-TAVR.

Conclusions:

  • The management of CAD in the expanding TAVR population requires further clarification.
  • More research is needed on pre-TAVR CAD assessment and revascularization strategies.
  • Understanding post-TAVR coronary interventions is crucial for comprehensive patient care.

Keywords:
aortic stenosiscoronary artery diseasepercutaneous coronary interventiontranscatheter aortic valve replacement

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