Key result
CAD affects ~50% of TAVR candidates, highlighting the need for optimal revascularization strategies.
Why the study?
As indications for TAVR expand to intermediate- and low-risk patients, the optimal management of CAD remains undetermined, and data on coronary interventions after TAVR are limited.
What is the optimal management of coronary artery disease in patients undergoing transcatheter aortic valve replacement?
What is the optimal management of coronary artery disease in patients undergoing transcatheter aortic valve replacement?
This review highlights the need for optimal management strategies for CAD in the expanding population of patients undergoing TAVR, including pre-procedural evaluation and post-TAVR coronary interventions.
CAD management in expanding TAVR populations lacks consensus; leaves open optimal revascularization timing pending prospective trials.
Coronary artery disease (CAD) and aortic stenosis share similar risk factors and underlying pathophysiology. Up to half of the patient population undergoing work-up for aortic valve replacement have underlying CAD, which can affect outcomes in patients with more severe disease. As the indications for transcatheter aortic valve replacement (TAVR) have expanded to intermediate and now low risk patients, the optimal management of CAD in this patient population still needs to be determined. This includes both pre-TAVR evaluation for CAD as well as indications for revascularization in patients undergoing TAVR. There is also limited data on coronary interventions after TAVR, including the incidence, feasibility and outcomes of patients undergoing percutaneous coronary intervention (PCI) after TAVR. This review provides an updated report of the current literature on CAD in TAVR patients, focusing on its prevalence, impact on outcomes, timing of revascularization and potential challenges with coronary interventions post-TAVR.
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Garg et al. (2022) conducted a review in Coronary artery disease in patients undergoing transcatheter aortic valve replacement. Coronary revascularization and evaluation was evaluated. Coronary artery disease is present in up to half of patients undergoing work-up for aortic valve replacement, highlighting the need to determine optimal pre- and post-TAVR revascularization strategies.
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