October 8, 2017Catheterization and Cardiovascular Interventions
Feasibility of coronary angiography and percutaneous coronary intervention after transcatheter aortic valve replacement using a Medtronic™ self‐expandable bioprosthetic valve
Why the study?
Is coronary angiography with or without PCI feasible and safe after TAVR using a supra-annular self-expandable bioprosthetic valve?
Population
28 patients who underwent 43 coronary angiographies after transcatheter aortic valve replacement for severe…
Design
Cohort
Authors
Discussion
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Implication
Supports selective post-TAVR coronary access with this valve; extends single-center data but should not yet change practice.
Key Points
- This research aims to assess the feasibility of coronary angiography and PCI following transcatheter aortic valve replacement using a self-expandable valve.
- Analyzed angiographic and clinical data from 403 patients treated with TAVR using Medtronic self-expandable valve from January 2012 to December 2016.
- Included patients who underwent coronary angiography with or without PCI after TAVR.
- 28 patients underwent 43 coronary angiographies with 97% left coronary arteries and 90% right coronary arteries successfully engaged.
- 90% of procedures were for acute coronary syndrome, primarily using the transfemoral approach (83%).
- No periprocedural complications reported, indicating safety in experienced hands.
Structured PICO
Is coronary angiography with or without PCI feasible and safe after TAVR using a supra-annular self-expandable bioprosthetic valve?
P
Population
28 patients who underwent 43 coronary angiographies after transcatheter aortic valve replacement (TAVR) for severe aortic stenosis using a Medtronic self-expandable valve. 39% women, >90% presenting with acute coronary syndrome.
I
Intervention
Coronary angiography with or without percutaneous coronary intervention (PCI) post-TAVR
O
Outcome
Feasibility of selectively engaging coronary arteries and procedural safety
Coronary angiography and PCI can be safely and successfully performed in patients who have previously undergone TAVR with a supra-annular self-expandable valve.
Cite This Study
Htun et al. (2017) studied this question.