Key result
This review summarizes the prevalence, clinical impact, pre- and post-procedural evaluation, and management of coronary artery disease in transcatheter aortic valve replacement recipients.
Why the study?
Controversial results exist regarding the impact of CAD on post-TAVR outcomes, and data remain scarce on the evaluation, management, and post-TAVR coronary access challenges in these patients.
Answers are grounded in this paper and cite their sources.
May inform TAVR decisions in CAD; leaves open need for confirmatory RCTs.
About one-half of transcatheter aortic valve replacement (TAVR) candidates have coronary artery disease (CAD), and controversial results have been reported regarding the effect of the presence and severity of CAD on clinical outcomes post-TAVR. In addition to coronary angiography, promising data has been recently reported on both the use of computed tomography angiography and the functional invasive assessment of coronary lesions in the work-up pre-TAVR. While waiting for the results of ongoing randomized trials, percutaneous revascularization of significant coronary lesions has been the routine strategy in TAVR candidates with CAD. Also, scarce data exists on the incidence, characteristics, and management of coronary events post-TAVR, and increasing interest exist on potential coronary access challenges in patients requiring coronary angiography/intervention post-TAVR. This review provides an updated overview of the current landscape of CAD in TAVR recipients, focusing on its prevalence, clinical impact, pre- and post-procedural evaluation and management, unresolved issues and future perspectives.
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Faroux et al. (2019) conducted a review in Coronary Artery Disease in Transcatheter Aortic Valve Replacement. Management of coronary artery disease was evaluated. This review summarizes the prevalence, clinical impact, pre- and post-procedural evaluation, and management of coronary artery disease in transcatheter aortic valve replacement recipients.
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