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September 1, 2013EuroIntervention48 citations

Severe aortic stenosis and coronary artery disease

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GSGiulio StefaniniSSStefan StorteckyBMBernhard Meier

Key Result

This review provides an overview of coronary artery disease prevalence, its impact on clinical outcomes, and treatment strategies in patients with severe aortic stenosis requiring SAVR or TAVI.

Key Points

  • This review article aims to highlight the prevalence of coronary artery disease in patients with severe aortic stenosis and the implications for treatment strategies.
  • Overview of the shared risk factors and mechanisms of coronary artery disease and aortic stenosis.
  • Analysis of trends in surgical approaches, including CABG and SAVR.
  • Discussion on the integration of TAVI for patients unfit for traditional surgery.
  • Concomitant CABG and SAVR procedures have doubled in the past decade among patients with severe aortic stenosis.
  • TAVI has expanded treatment options for elderly high-risk patients with severe aortic stenosis and coronary artery disease.

Structured PICO

P
Population
Patients with severe aortic stenosis and concomitant coronary artery disease requiring surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI)
I
Intervention
Treatment strategies including concomitant coronary artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR), or transcatheter aortic valve implantation (TAVI)

This review provides an overview of the prevalence, clinical impact, and treatment strategies for patients with coexisting severe aortic stenosis and coronary artery disease.

Abstract

Coronary artery disease (CAD) and aortic stenosis (AS) share pathophysiological mechanisms and risk factors. Moreover, the prevalence of CAD increases among elderly patients with severe AS since disease progression is strongly associated with age for both CAD and AS. These factors contribute to the frequent coexistence of CAD and AS. Patients with concomitant AS and CAD are characterised by higher baseline risk profiles with a larger number of comorbidities as compared to patients with isolated AS. Therefore, adequate therapeutic strategies are crucial for the treatment of these patients. The number of patients undergoing concomitant coronary artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR) doubled during the last decade. Moreover, the development and rapid integration of transcatheter aortic valve implantation (TAVI) into clinical practice in western European countries has further extended invasive treatment of AS to elderly high-risk patients not considered suitable candidates for SAVR, frequently presenting with CAD. The aim of this review article is to provide an overview on CAD prevalence, impact on clinical outcomes, and treatment strategies in patients with severe AS requiring SAVR or TAVI.

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Cite This Study

Stefanini et al. (2013) conducted a review in Severe aortic stenosis and coronary artery disease. Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) was evaluated. This review provides an overview of coronary artery disease prevalence, its impact on clinical outcomes, and treatment strategies in patients with severe aortic stenosis requiring SAVR or TAVI.

synapsesocial.com/papers/6a6b0518285b5e3c3db3a15bhttps://doi.org/10.4244/eijv9ssa12
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