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

doi:10.1016/j.jacc.2013.01.096

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 journal › Review article › peer-review

217 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 language	English (US)
Pages (from-to)	1-10
Number of pages	10
Journal	Journal of the American College of Cardiology
Volume	62
Issue number	1
DOIs	https://doi.org/10.1016/j.jacc.2013.01.096
State	Published - 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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10.1016/j.jacc.2013.01.096

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Goel, S. S., Ige, M., Tuzcu, E. M., Ellis, S. G., Stewart, W. J., Svensson, L. G., Lytle, B. W., & Kapadia, S. R. (2013). Severe aortic stenosis and coronary artery disease - Implications for management in the transcatheter aortic valve replacement era: A comprehensive review. Journal of the American College of Cardiology, 62(1), 1-10. https://doi.org/10.1016/j.jacc.2013.01.096

Severe aortic stenosis and coronary artery disease - Implications for management in the transcatheter aortic valve replacement era: A comprehensive review. / Goel, Sachin S.; Ige, Mobolaji; Tuzcu, E. Murat et al.
In: Journal of the American College of Cardiology, Vol. 62, No. 1, 02.07.2013, p. 1-10.

Research output: Contribution to journal › Review article › peer-review

Goel, SS, Ige, M, Tuzcu, EM, Ellis, SG, Stewart, WJ, Svensson, LG, Lytle, BW & Kapadia, SR 2013, 'Severe aortic stenosis and coronary artery disease - Implications for management in the transcatheter aortic valve replacement era: A comprehensive review', Journal of the American College of Cardiology, vol. 62, no. 1, pp. 1-10. https://doi.org/10.1016/j.jacc.2013.01.096

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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.",

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

Abstract

Keywords

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