E-34 | Incidence and Factors associated with Unplanned Coronary Angiography After Transcatheter Aortic Valve Replacement in Coronary Artery Disease Patients

To evaluate the incidence and the factors association with unplanned coronary angiography after transcatheter aortic valve replacement(TAVR) in known coronary artery disease patient. Unplanned coronary angiography after TAVR may present significant challenges. The aim of this study is to identify the CAD patient who is at risk for unplanned angiography after TAVR. All patients who have coronary artery disease and aortic stenosis underwent TAVR between July 2015 to December 2021 were included. Incidence and factors associated with unplanned angiography were identified. The study population consisted of 724 patients (median age 82 yrs, 72.1% male) with an average of STS-PROM 3.70%. Overall, 76 (10.5%) had unplanned post-TAVR coronary angiography at a median time of 13 months and 6.1% has subsequent PCI. In multivariable analysis, factors associated with unplanned angiography were multi-vessel disease (HR 1.96, 95%CI 1.00 - 3.86, P = 0.049), Prior CABG (HR 1.75, 95%CI 1.02 – 3.01, P= 0.041). Use of self -expandable valve (HR 0.52, 95%CI 0.30-0.89, P=0.018); However, LVEF did not reach significance. Patient with high burden of coronary artery disease including multivessel disease, post CABG would have higher risk of unplanned angiography after TAVR. Those factors needed to take into consideration for the lifetime management.