Severe aortic stenosis and coronary artery disease - Implications for management in the transcatheter aortic valve replacement era: A comprehensive review

Sachin S. Goel, Mobolaji Ige, E. Murat Tuzcu, Stephen G. Ellis, William J. Stewart, Lars G. Svensson, Bruce W. Lytle, Samir R. Kapadia

Research output: Contribution to journalReview articlepeer-review

156 Scopus citations

Abstract

Management of coronary artery disease (CAD) in patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) is posing challenges. Due to limited and heterogeneous data on the prevalence and clinical impact of CAD on the outcomes of TAVR and the management strategies for CAD in patients undergoing TAVR, we performed a comprehensive review of the literature. Significant CAD is present in 40% to 75% of patients undergoing TAVR. The impact of CAD on outcomes after TAVR remains understudied. Based on existing data, not all patients require revascularization before TAVR. Percutaneous coronary intervention (PCI) should be considered for severely stenotic lesions in proximal coronaries that subtend a large area of myocardium at risk. Ongoing studies randomizing patients to surgical or percutaneous management strategies for severe AS will help provide valuable data regarding the impact of CAD on TAVR outcomes, the role of PCI, and its timing in relation to TAVR.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalJournal of the American College of Cardiology
Volume62
Issue number1
DOIs
StatePublished - Jul 2 2013

Keywords

  • aortic stenosis
  • coronary artery disease
  • surgical aortic valve replacement
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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