Coronary artery disease and TAVI: Current evidence on a recurrent issue

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[Released on 20/04/2023]

Authors: Mauro Massussi MD , Marianna Adamo MD , Fabrizio Rosati MD , Giuliano Chizzola MD , Marco Metra MD , Giuseppe Tarantini MD

Abstract

Coronary artery disease (CAD) is a frequent finding in patients with aortic stenosis (AS). Concomitant coronary artery bypass and aortic valve replacement is considered the gold standard treatment in surgical candidates. However, limited evidence is available regarding the role of coronary revascularization in patients undergoing transcatheter aortic valve implantation (TAVI). How to evaluate CAD severity in patients with AS, whether percutaneous coronary intervention (PCI) needs to be performed and what is the timing for revascularization to minimize procedural risks, remains matters of debate. The aim of this review is to summarize epidemiology, diagnostic tools and possible options for CAD management in patients undergoing TAVI with specific focus on the pros and the cons of the different timing of PCI.

Keywords: aortic valve disease; coronary artery disease; transcatheter valve implantation.

Wiley

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Coronary artery disease and TAVI: Current evidence on a recurrent issue

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Abstract

Coronary artery disease (CAD) is a frequent finding in patients with aortic stenosis (AS). Concomitant coronary artery bypass and aortic valve replacement is considered the gold standard treatment in surgical candidates. However, limited evidence is available regarding the role of coronary revascularization in patients undergoing transcatheter aortic valve implantation (TAVI). How to evaluate CAD severity in patients with AS, whether percutaneous coronary intervention (PCI) needs to be performed and what is the timing for revascularization to minimize procedural risks, remains matters of debate. The aim of this review is to summarize epidemiology, diagnostic tools and possible options for CAD management in patients undergoing TAVI with specific focus on the pros and the cons of the different timing of PCI.

Keywords: aortic valve disease; coronary artery disease; transcatheter valve implantation.

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