Optimized Screening of Coronary Artery Disease With Invasive Coronary Angiography and Ad Hoc Percutaneous Coronary Intervention During Transcatheter Aortic Valve Replacement

• DOI: 10.1161/circinterventions.117.005234
• Publication Date: 2017-08-03T01:00:30Z
• Authors: Marco Barbanti; Denise Todaro; Giuliano Costa; Gerlando Pilato; Andrea Picci; Simona Gulino; Piera Capranzano; Ketty La Spina; Emanuela Di Simone; Paolo D’Arrigo; Wanda Deste; Antonino Indelicato; Stefano Cannata; Daniela Giannazzo; Sebastiano Immè; Claudia Tamburino; Martina Patanè; Sergio Buccheri; Davide Capodanno; Carmelo Sgroi; Corrado Tamburino
• Keywords: Stroke; Valve replacement

We sought to describe an optimized approach coronary artery disease (CAD) screening and management in patients undergoing transcatheter aortic valve replacement (TAVR).When invasive angiography showed CAD, the treatment strategy completeness of revascularization was determined based on anatomy. TAVR performed same setting if percutaneous intervention (PCI) uncomplicated; otherwise postponed. A total 604 CAD at time procedure were prospectively included this study. Severe found 136 (22.5%). Among with severe 53 (8.8%) underwent uncomplicated PCI. After PCI, postponed 2 (0.3%). In 83 (13.8%), that left untreated. TAVR, all-cause cardiovascular 30-day mortality rates 2.4% 1.4%, respectively. Disabling stroke, myocardial infarction, life-threatening bleeding occurred 0.5%, 0.8%, 4.0% patients, Acute kidney injury II or III rate 3.3%. At years, 14.1%. stroke infarction 2.5% 1.8% Patients PCI session had similar composite death, disabling when compared without untreated (TAVR+PCI: 10.4%; untreated: 15.4%; no-CAD: 14.8%; P=0.765).In ad hoc during is feasible not associated increased periprocedural risks. followed by outcomes than which performed.