Expanding TAVI options: elective rotational atherectomy during trans-catheter aortic valve implantation

Cardiovasc Revasc Med. 2015 Jan-Feb;16(1):58-61. doi: 10.1016/j.carrev.2014.11.003. Epub 2014 Nov 20.

Abstract

Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described.

Keywords: Aortic valve stenosis; Catheter-based coronary interventions; Rotational atherectomy; Trans-catheter aortic valve implantation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / therapy*
  • Atherectomy, Coronary*
  • Cardiac Catheterization* / instrumentation
  • Coronary Angiography
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy*
  • Female
  • Heart Valve Prosthesis Implantation / instrumentation
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Male
  • Treatment Outcome