Evaluation and management of coronary artery disease in transcatheter aortic valve implantation candidates with severe aortic stenosis and coronary artery disease: technology and techniques.

Autor:	Laterra G; Department of Medicine and Surgery, Università degli Studi di Enna 'Kore', Enna, Italy.; Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy., Strazzieri O; Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy., Reddavid C; Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy., Scalia L; Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy., Agnello F; Department of Medicine and Surgery, Università degli Studi di Enna 'Kore', Enna, Italy.; Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy., Lavalle S; Department of Medicine and Surgery, Università degli Studi di Enna 'Kore', Enna, Italy.; Division of Radiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy., Barbanti M; Department of Medicine and Surgery, Università degli Studi di Enna 'Kore', Enna, Italy.; Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy.
Jazyk:	angličtina
Zdroj:	Expert review of medical devices [Expert Rev Med Devices] 2024 Oct; Vol. 21 (10), pp. 915-925. Date of Electronic Publication: 2024 Sep 13.
DOI:	10.1080/17434440.2024.2401492
Abstrakt:	Introduction: Patients with severe aortic stenosis referred for transcatheter aortic valve implantation (TAVI) often present with concomitant coronary artery disease (CAD). The management of CAD in these patients remains a topic of debate, encompassing the evaluation and timing of percutaneous coronary intervention (PCI). Areas Covered: This review article aims to offer an overview of the role of coronary revascularization in TAVI patients, highlighting the advantages and disadvantages of different strategies: PCI before, concomitant with, and after TAVI. Considering that TAVI indications are expanding and patients with low surgical risk are now being referred for TAVI, the rate of PCI among patients undergoing TAVI is expected to increase. Historically, PCI was performed before TAVI. However, there is now a growing trend to defer PCI until after TAVI. Expert Opinion: It is plausible that in the future, there will be an increase in PCI after TAVI due to several factors: first, multiple studies have shown the safety of TAVI even in patients with severe untreated CAD; second, improvements in TAVI device implantation techniques, such as commissural alignment and patient-specific device selection, have improved access to the coronary arteries post-TAVI.
Databáze:	MEDLINE
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