Key result
Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation requires careful pre-procedural assessment, procedural planning, and post-procedural optimization.
Why the study?
CAD is common in severe aortic stenosis, and expanding TAVI to younger patients raises challenges regarding pre-procedural management, procedural coronary obstruction, and post-TAVI coronary access.
This review provides guidance on managing coronary artery disease in patients undergoing TAVI, emphasizing pre-procedural assessment, procedural planning to avoid coronary obstruction, and optimization of post-procedural coronary access.
Emphasizes pre-TAVI CAD planning for future coronary access in younger patients; leaves open optimal revascularization strategies.
Coronary artery disease (CAD) is common in patients with severe aortic stenosis. With the advent of transcatheter aortic valve implantation (TAVI) as a therapeutic option, management of CAD in such patients has undergone a revolution. Younger patients are now candidates for treatment, and have a greater life-time probability of requiring post-TAVI coronary access. Considerations include pre-procedural assessment and revascularisation, procedural planning to avoid coronary obstruction as well as optimisation of post-procedural coronary access. The authors review the challenges of managing CAD in TAVI patients, shed light on the evidence base, and provide guidance on how to optimise management.
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Lim et al. (2022) conducted a review in Coronary artery disease and severe aortic stenosis. Management of coronary artery disease was evaluated. Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation requires careful pre-procedural assessment, procedural planning, and post-procedural optimization.
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