Coronary Artery Revascularization in Patients Undergoing Transcatheter Aortic Valve Replacement

Cardiol Clin. 2024 Aug;42(3):333-338. doi: 10.1016/j.ccl.2024.03.001. Epub 2024 Apr 23.

Abstract

Patients with concomitant severe aortic stenosis and significant coronary artery disease present a diagnostic and therapeutic challenge in clinical practice. There are no clear-cut guidelines as to the timing of revascularization in these patients who are referred for transcatheter aortic valve replacement (TAVR). This article aims to show that in patients without high-grade proximal coronary artery disease, revascularization after TAVR is safe, feasible, and practical. Additionally, the use of preoperative TAVR computed tomographic angiography might be used in both intermediate and high-risk patients rather than invasive coronary angiography to assess for significant proximal coronary artery disease to help guide the timing of revascularization.

Keywords: Aortic stenosis; CTA; PCI; Revascularization; TAVR; Transcatheter aortic valve replacement.

Publication types

  • Review

MeSH terms

  • Aortic Valve Stenosis* / surgery
  • Coronary Angiography
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / surgery
  • Humans
  • Myocardial Revascularization / methods
  • Percutaneous Coronary Intervention / methods
  • Transcatheter Aortic Valve Replacement* / methods