Coronary Artery Disease and Revascularization in Patients Undergoing Transcatheter Aortic Valve Replacement

TL;DR

This review discusses how coronary artery disease affects patients undergoing aortic valve replacement and the challenges of managing it.

Contribution

The paper provides an updated review on CAD management in TAVR patients, focusing on revascularization timing and post-TAVR interventions.

Findings

Up to half of TAVR patients have underlying CAD, which impacts outcomes.

There is limited data on coronary interventions after TAVR, including PCI feasibility and outcomes.

Abstract

Coronary artery disease (CAD) and aortic stenosis share similar risk factors and
underlying pathophysiology. Up to half of the patient population undergoing
work-up for aortic valve replacement have underlying CAD, which can affect
outcomes in patients with more severe disease. As the indications for
transcatheter aortic valve replacement (TAVR) have expanded to intermediate and
now low risk patients, the optimal management of CAD in this patient population
still needs to be determined. This includes both pre-TAVR evaluation for CAD as
well as indications for revascularization in patients undergoing TAVR. There is
also limited data on coronary interventions after TAVR, including the incidence,
feasibility and outcomes of patients undergoing percutaneous coronary intervention (PCI) after TAVR. This review
provides an updated report of the current literature on CAD in TAVR patients,
focusing on its prevalence, impact on outcomes, timing of revascularization and
potential challenges with coronary interventions post-TAVR.