Key result
Managing concomitant CAD and AS requires multidisciplinary teams to individualize SAVR/CABG or TAVR/PCI strategies.
Why the study?
Advancements in transcatheter aortic valve therapies have shifted the approach to aortic stenosis with concomitant CAD, but data on CAD management remain largely limited to single-center or retrospective studies.
The management of concomitant CAD in patients undergoing TAVR requires an individualized, multidisciplinary approach due to the lack of robust randomized data.
Supports individualized multidisciplinary decisions in CAD-AS; leaves open optimal hybrid strategies pending RCTs.
Aortic stenosis (AS) is a common valve disorder among the elderly, and these patients frequently have concomitant coronary artery disease (CAD). Risk factors for calcific AS are similar to those for CAD. Historically, the treatment of these conditions involved simultaneous surgical replacement of the aortic valve (AV) with coronary artery bypass grafting. Since the advancement of transcatheter AV therapies, there have been tremendous advancements in the safety, efficacy, and feasibility of this procedure with expanding indications. This has led to a paradigm shift in our approach to the patient with AS and concomitant CAD. Data regarding the management of CAD in patients with AS are largely limited to single-center studies or retrospective analyses. This article aims to review available literature around the management of CAD in patients with AS and assist in the current understanding in approaches toward management.
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Belur et al. (2023) conducted a review in Aortic stenosis and coronary artery disease. Management strategies for CAD in AS (TAVR/PCI, SAVR/CABG) was evaluated. Current evidence on managing concomitant coronary artery disease and aortic stenosis is heterogeneous, requiring a multidisciplinary approach to individualize strategies like SAVR with CABG or TAVR with PCI.
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