Key result
Simultaneous TAVI and coronary stenting achieves ~100% procedural success without increasing 30-day mortality versus TAVI alone.
Why the study?
The study was conducted to evaluate the effectiveness of simultaneous TAVI and coronary stenting in elderly and old patients with AVAS and CAD at high surgical risk.
Is simultaneous TAVI and PCI safe and feasible compared to TAVI alone in elderly high-risk patients with AVAS and CAD?
Cohort (n=121)
Is simultaneous TAVI and PCI safe and feasible compared to TAVI alone in elderly high-risk patients with AVAS and CAD?
Simultaneous TAVI and PCI is feasible and safe in elderly high-risk patients with severe aortic stenosis and CAD, with comparable short-term outcomes to TAVI alone.
Answers are grounded in this paper and cite their sources.
Supports feasibility of simultaneous TAVI and PCI in high-risk elderly patients; leaves open need for 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 follow-up, 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. (2022) conducted a cohort in Aortic Valve Atherosclerotic Stenosis (AVAS) and Coronary Artery Disease (CAD) (n=121). Simultaneous TAVI and coronary stenting (PCI) vs. TAVI alone was evaluated on 30-day mortality and severe complication rates. Simultaneous TAVI and coronary stenting in elderly patients with severe aortic stenosis and CAD achieved 100% procedural success with no significant difference in 30-day mortality versus TAVI alone.
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