Abstract
Severe calcific aortic stenosis (AS) and coronary artery disease (CAD) have common risk factors and are frequently encountered in the same patient in clinical practice. CAD has been reported in ≥ 50% of AS patients undergoing both surgical treatment and transcatheter aortic valve implantation (TAVI). In the last two decades, TAVI has been established as a less invasive alternative to surgery. Recently, more and more young and low surgical risk patients undergo TAVI. Despite the high prevalence of CAD in patients treated with TAVI, the management strategy of concomitant CAD in these patients remains an area of considerable uncertainty. This review provides an updated overview of the current knowledge about this topic and offers points for reflection about the best approach to use.
Highlights
Aortic valve stenosis (AS) is the most common valvular heart disease undergoing surgical treatment in developed countries[1]
Multicenter registries[65,66,67] showed that coronary angiography and percutaneous coronary intervention (PCI) in Transcatheter aortic valve implantation (TAVI) patients affected by acute coronary syndrome is usually successful but coronary ostia cannulation failure was associated with poorer outcomes
Coronary artery disease is a common finding in patients with degenerative aortic valve stenosis with a prevalence estimated around 40%-75%
Summary
Aortic valve stenosis (AS) is the most common valvular heart disease undergoing surgical treatment in developed countries[1]. Several observational and retrospective studies comparing TAVI vs TAVI and percutaneous coronary intervention (PCI) in patients with CAD did not find a significant difference in terms of mortality [Supplementary Table 2]. The SURTAVI trial[24] was the only randomized study to compare both percutaneous (TAVI + PCI) and surgical (SAVR + CABG) treatment strategies in patients with severe AS and no-complex CAD.
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