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Updated: Jan 22, 2026

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Coronary artery disease in patients undergoing transcatheter aortic valve replacement: Current evidence and future

Bahaa El Deen Wehbeh1, Moied Al Sakan2, Jamil Francis2

  • 1Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

American Heart Journal Plus : Cardiology Research and Practice
|January 21, 2026
PubMed

Insights

Managing coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) is complex. Revascularization may benefit those with complex CAD, but routine intervention for stable CAD offers limited advantages.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Surgery

Background:

  • Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist, posing management challenges.
  • Optimal treatment strategies for CAD in patients undergoing transcatheter aortic valve replacement (TAVR) lack clear definition due to limited evidence.

Purpose of the Study:

  • To review the epidemiology and pathophysiology linking CAD and AS.
  • To summarize diagnostic approaches for CAD in the TAVR population.
  • To evaluate revascularization strategies, focusing on percutaneous coronary intervention (PCI) timing relative to TAVR.

Main Methods:

  • Comprehensive literature review integrating current evidence.
  • Analysis of diagnostic algorithms for CAD in TAVR candidates.
  • Evaluation of revascularization strategies, including PCI timing.

Main Results:

  • Routine PCI for stable CAD in TAVR candidates shows limited benefit.
  • Revascularization for complex CAD or high anatomical burden may improve outcomes.
  • Characterization of post-TAVR coronary events, their mechanisms, and prognostic impact.

Conclusions:

  • Personalized revascularization strategies are crucial for CAD patients undergoing TAVR.
  • Further research is needed to optimize outcomes in this high-risk cohort.
  • Emerging strategies aim to improve both ischemic and procedural results post-TAVR.

Keywords:
Aortic valve implantationCoronary artery diseaseTranscatheter aortic valve replacement

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