Timing and Outcomes of PCI in the TAVR Era

  • Konstantinos V. Voudris
  • Peter Petropulos
  • Panagiotis Karyofillis
  • Konstantinos Charitakis
Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
  • 60 Downloads
Part of the following topical collections:
  1. Topical Collection on Coronary Artery Disease

Abstract

Purpose of review

Transcatheter aortic valve replacement (TAVR) has become an established therapy for patients with symptomatic severe aortic stenosis (AS). As the number of patients referred for TAVR increases, so does the prevalence of untreated obstructive coronary artery disease (CAD) in the population under evaluation. Despite the high prevalence of CAD in patients treated with TAVR, the management strategy of concomitant CAD in these patients remains an area of considerable uncertainty.

Recent findings

Percutaneous coronary intervention (PCI) in patients with CAD and severe AS has been shown to be feasible and safe. Whether revascularization before, during, or after TAVR is optimal remains a subject of debate. All three approaches represent valid strategies with advantages and disadvantages that need to be carefully weighed on an individual basis.

Summary

Current expert opinions recommend that PCI should be performed before or at the time of TAVR as long as the risk of the procedure does not outweigh the potential benefits. The results of large clinical trials evaluating the optimal revascularization time are closely awaited.

Keywords

TAVR PCI CAD Coronary artery disease 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Konstantinos V. Voudris
    • 1
    • 2
  • Peter Petropulos
    • 3
  • Panagiotis Karyofillis
    • 4
  • Konstantinos Charitakis
    • 5
  1. 1.Department of MedicineUniversity of Illinois at Chicago/Advocate Christ Medical CenterChicagoUSA
  2. 2.Department of MedicineAdvocate Christ Medical CenterOak LawnUSA
  3. 3.Department of MedicineCedars Sinai Medical CenterLos AngelesUSA
  4. 4.Division of Interventional CardiologyOnassis Cardiac Surgery CenterAthensGreece
  5. 5.Department of Cardiology, McGovern Medical SchoolUniversity of Texas Health Science CenterHoustonUSA

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