Key result
Simultaneous TAVI and PCI yields 0% 30-day mortality, matching isolated TAVI.
Why the study?
To evaluate the effectiveness of simultaneous TAVI and coronary stenting in elderly and old patients with AVAS and CAD at high surgical risk.
Does simultaneous TAVI and PCI improve safety and clinical outcomes in elderly patients with severe aortic stenosis and coronary artery disease?
Cohort (n=121)
No
Does simultaneous TAVI and PCI improve safety and clinical outcomes in elderly patients with severe aortic stenosis and coronary artery disease?
Simultaneous TAVI and PCI is a feasible and safe strategy for elderly patients with severe aortic stenosis and concomitant coronary artery disease, showing comparable short-term outcomes to staged procedures.
Answers are grounded in this paper and cite their sources.
Supports safety of simultaneous TAVI+PCI in selected elderly patients; hypothesis-generating and requires randomized confirmation before practice change.
Aim: To evaluate the effectiveness of simultaneous TAVI and coronary stenting in elderly and old patients with AVAS and CAD at high surgical risk. Methods: The study comprised 121 patients who underwent TAVI. They were assigned to two groups: I–patients who underwent TAVI with simultaneous coronary stenting (n = 30); II–patients with AVAS without severe stenotic changes in the coronary arteries. They underwent only TAVI (n = 91). The in-hospital period and the mid-term results have been studied. Results: The success of simultaneous TAVI and PCI was 100%. There were no intra- or perioperative deaths, acute myocardial infarction, acute brain stroke, or acute renal failure requiring dialysis. During the 6-month followup, one patient died from cancer. There were no other serious complications. The left bundle branch block occurred in 23.3% of cases and regurgitation (leakage) on the aortic valve in 6.6% of cases. Conclusion: Simultaneous TAVI and coronary stenting in elderly and old patients with severe aortic stenosis and CAD are feasible and safe. Within the first 30 days after the procedure, there were no significant differences in mortality and severe complication rates between the two groups.
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Iosseliani et al. (2023) conducted a cohort in Aortic valve atherosclerotic stenosis and coronary artery disease (n=121). Simultaneous transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) vs. Isolated TAVI was evaluated on 30-day mortality (p=0.061). Simultaneous transcatheter aortic valve implantation and percutaneous coronary intervention in elderly patients with severe aortic stenosis and coronary artery disease resulted in 0% 30-day mortality, showing no significant difference compared to isolated TAVI.
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