Key result
Managing concomitant CAD in TAVI requires a personalized approach due to limited randomized data.
Why the study?
With the extension of TAVI to intermediate- and low-risk patients, the pre-TAVI evaluation of CAD and indications for revascularization remain debated.
What is the optimal evaluation and management strategy for concomitant coronary artery disease in patients undergoing transcatheter aortic valve implantation?
What is the optimal evaluation and management strategy for concomitant coronary artery disease in patients undergoing transcatheter aortic valve implantation?
This review emphasizes a shift towards more selective, physiology-guided, and potentially deferred revascularization strategies for stable CAD in patients undergoing TAVI, challenging historical practices of routine pre-TAVI PCI.
Personalized CAD strategies warranted in TAVI patients; leaves open optimal revascularization pending randomized trials.
Significant coronary artery disease (CAD) and severe aortic stenosis (AS) are frequent findings in patients who undergo transcatheter aortic valve implantation (TAVI). With the extension of TAVI in patients who have intermediate and even low surgical risk, the optimal evaluation and management of concomitant CAD needs to be determined. Both pre-TAVI evaluation of CAD and indications for revascularization remain a matter of debate. In this review, we provide an updated overview of the prevailing landscape of CAD in patients undergoing TAVI with a focus on its prognostic impact, diagnostic evaluation pre-procedure, indications for revascularization, optimal timing of revascularization, and future directions.
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Raval et al. (2024) conducted a review in Coronary artery disease and severe aortic stenosis. Evaluation and management of coronary artery disease was evaluated. Evaluation and management of concomitant coronary artery disease in patients undergoing transcatheter aortic valve implantation requires a personalized approach due to a lack of robust randomized data.
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