Coronary artery disease in patients undergoing TAVI: why, what, when and how to treat.

Stefanini, Giulio; Stortecky, Stefan; Wenaweser, Peter Martin; Windecker, Stephan (2014). Coronary artery disease in patients undergoing TAVI: why, what, when and how to treat. EuroIntervention, 10 Suppl U, U69-75. Europa Digital & Publishing 10.4244/EIJV10SUA10

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Coronary artery disease (CAD) and aortic valve stenosis (AS) are frequently coexisting. It has been reported that CAD is present in 40% of patients with AS undergoing surgical aortic valve replacement, and in up to 60% of patients with AS undergoing transcatheter aortic valve implantation (TAVI). Elderly patients with CAD and AS are characterised by higher baseline risk profiles as compared to patients with isolated AS, increasing the complexity of their therapeutic management. In patients with CAD and AS the combination of coronary artery bypass grafting (CABG) and surgical aortic valve replacement has been shown to improve survival. Therefore, CABG is recommended in patients with CAD and AS undergoing surgical aortic valve replacement according to current guidelines of the European Society of Cardiology (ESC) and of the American College of Cardiology Foundation/American Heart Association (ACCF/AHA). Conversely, whether the presence of CAD has any prognostic implications in elderly patients with severe AS undergoing TAVI is still a matter of debate. Of note, according to the most recent ESC guidelines on myocardial revascularisation, percutaneous revascularisation should be considered in patients undergoing TAVI with a stenosis >70% in proximal coronary segments (class IIa, level of evidence C). The aim of this article is to provide an overview of evidence supporting the need for coronary revascularisation in patients with severe AS and CAD undergoing TAVI, and to summarise optimal timing and treatment modalities for percutaneous coronary interventions in these patients.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Stefanini, Giulio, Stortecky, Stefan, Wenaweser, Peter Martin, Windecker, Stephan
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1774-024X
Publisher:	Europa Digital & Publishing
Language:	English
Submitter:	Judith Liniger
Date Deposited:	06 May 2015 09:05
Last Modified:	05 Dec 2022 14:39
Publisher DOI:	10.4244/EIJV10SUA10
PubMed ID:	25256334
URI:	https://boris.unibe.ch/id/eprint/61982