Coronary Risk in Transcatheter Aortic Valve Replacement, Overview of Data, Challenges, and Best Practices

Cardiol Clin. 2024 Aug;42(3):361-371. doi: 10.1016/j.ccl.2024.02.016. Epub 2024 Mar 22.

Abstract

Coronary artery obstruction is a rare complication of transcatheter aortic valve replacement (TAVR). This risk increases in TAVR-valve-in-valve procedure. Several anatomic risk factors were described in many studies to identify the predictive elements of coronary artery occlusion on computed tomography cardiac scan. Rescue percutaneous coronary intervention was the first approach described to treat this complication with a high mortality rate. Later on, preventive chimney stenting technique was evaluated and results showed that is a safe and effective strategy but it leads to a difficult coronary access later. New preventive techniques are being evaluated recently (Basilica and Shorctut).

Keywords: BASILICA; Chimney technique; Coronary occlusion; ShortCut; TAVR.

Publication types

  • Review

MeSH terms

  • Aortic Valve Stenosis* / surgery
  • Coronary Angiography / methods
  • Coronary Occlusion* / diagnosis
  • Coronary Occlusion* / etiology
  • Coronary Occlusion* / surgery
  • Global Health
  • Humans
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Risk Assessment
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects