Percutaneous Coronary Intervention in Transcatheter Aortic Valve Implantation Patients: Overview and Practical Management

Frontiers in Cardiovascular Medicine

Maren Weferling¹  Christian W. Hamm²  Won-Keun Kim³ 

[1] Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany;German Center for Cardiovascular Research (DZHK), Frankfurt, Germany;Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany;German Center for Cardiovascular Research (DZHK), Frankfurt, Germany;Department of Cardiology, University Hospital of Giessen, Giessen, Germany;Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany;German Center for Cardiovascular Research (DZHK), Frankfurt, Germany;Department of Cardiology, University Hospital of Giessen, Giessen, Germany;Department of Cardio-Thoracic Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany;

关键词: TAVI;    coronary angiography;    PCI;    coronary artery disease;    acute coronary syndrome;   

DOI  :  10.3389/fcvm.2021.653768

来源: Frontiers

【 摘 要 】

Coronary artery disease (CAD) is present in 40–75% of patients undergoing transcatheter aortic valve implantation (TAVI) for severe symptomatic aortic stenosis. Currently, the indication for TAVI is expanding toward younger patients at lower surgical risk. Given the progressive nature of CAD, the necessity for coronary angiography (CA), including percutaneous coronary intervention (PCI), will subsequently increase as in the future TAVI patients will be younger and have a longer life expectancy. Data on the impact of PCI in patients with severe CAD scheduled for TAVI are controversial, and although European and US guidelines recommend PCI before TAVI, the optimal timing for PCI remains unclear due to a lack of evidence. Depending on the valve type, position, and axial alignment of the implanted device, CA and/or PCI after TAVI can be challenging. Hence, every interventionalist should be familiar with the different types of transcatheter heart valves and their characteristics and technical issues that can arise during invasive coronary procedures. This review provides an overview of current data regarding the prevalence and clinical implications of CAD and PCI in TAVI patients and includes useful guidance for practical management in the clinical routine.

【 授权许可】

CC BY