Key result
Hybrid AVR plus PTCA increases long-term MIs ~400% versus AVR plus CABG, despite lower severity.
Why the study?
Does hybrid intervention (aortic valve replacement + PTCA) improve outcomes compared to aortic valve replacement + CABG in patients with concomitant coronary artery disease and aortic stenosis?
RCT (n=120)
randomized
Does hybrid intervention (aortic valve replacement + PTCA) improve outcomes compared to aortic valve replacement + CABG in patients with concomitant coronary artery disease and aortic stenosis?
In patients with aortic stenosis and CAD, a hybrid approach of AVR and PTCA offers comparable survival and stroke rates to AVR and CABG, with better valve gradients but a higher rate of mild myocardial infarctions.
Hybrid AVR+PTCA increases long-term MI risk versus AVR+CABG; challenges hybrid revascularization preference in combined aortic stenosis and CAD.
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Zubarev et al. (2016) conducted an RCT in concomitant coronary artery disease and aortic stenosis (n=120). Aortic valve replacement + percutaneous transluminal coronary angioplasty (PTCA) vs. Aortic valve replacement + coronary artery bypass grafting (CABG) was evaluated on Myocardial infarction rate during long-term follow-up. Hybrid intervention with aortic valve replacement and PTCA resulted in a higher long-term myocardial infarction rate compared to AVR and CABG (12.5% vs 2.5%), but with lower infarction severity.
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