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Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation

Background. Coronary artery disease (CAD) is a common finding among patients undergoing trans-catheter aortic valve implantation (TAVI), who often present severely calcified coronary lesions. Evidence is scarce about the use of rotational atherectomy (RA) in this setting, in particular regarding lon...

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Autores principales: Lunardi, Mattia, Pighi, Michele, Venturi, Gabriele, Del Sole, Paolo Alberto, Pesarini, Gabriele, Mainardi, Andrea, Scarsini, Roberto, Ferrero, Valeria, Gottin, Leonardo, Ribichini, Flavio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796033/
https://www.ncbi.nlm.nih.gov/pubmed/33396185
http://dx.doi.org/10.3390/jcm10010112
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author Lunardi, Mattia
Pighi, Michele
Venturi, Gabriele
Del Sole, Paolo Alberto
Pesarini, Gabriele
Mainardi, Andrea
Scarsini, Roberto
Ferrero, Valeria
Gottin, Leonardo
Ribichini, Flavio
author_facet Lunardi, Mattia
Pighi, Michele
Venturi, Gabriele
Del Sole, Paolo Alberto
Pesarini, Gabriele
Mainardi, Andrea
Scarsini, Roberto
Ferrero, Valeria
Gottin, Leonardo
Ribichini, Flavio
author_sort Lunardi, Mattia
collection PubMed
description Background. Coronary artery disease (CAD) is a common finding among patients undergoing trans-catheter aortic valve implantation (TAVI), who often present severely calcified coronary lesions. Evidence is scarce about the use of rotational atherectomy (RA) in this setting, in particular regarding long-term outcome. Methods. RA was performed on severely calcified coronary lesions concomitant with TAVI in a consecutive series of patients treated between 2010 and 2020. Immediate and long-term clinical outcomes are reported. Results. A concomitant CAD (coronary stenosis visually > 50%) was observed in 402/845 (47.6%) consecutive patients undergoing TAVI at the University Hospital of Verona. Angioplasty was performed in 104 patients (12.3%). Among these, 19 patients (18.3%, 20 coronary arteries), were treated with RA after TAVI: 10 after implantation of a balloon-expandable trans-catheter valve and 9 after a self-expandable valve. All procedures were successful. Hypotension occurred in 3 patients (15.8%), with rapid recovery after the procedure; CI-AKI (contrast-induced acute kidney injury) in 3 patients (15.8%), of which two recovered within discharge. At a median follow-up of 21.5 months (Q1–3: 6–36) event free survival was 83.3%. Only one patient suffered a target vessel failure >2 years after RA. Neither stroke nor peri-procedural infarctions were detected. Conclusions. RA concomitant with TAVI was feasible and safe in patients treated with implantation of either self-expandable, or balloon-expandable trans-catheter aortic valves. Long-term clinical events related to the coronary procedure were extremely infrequent and the survival rate at median follow-up of 21.5 months was 83.3%.
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spelling pubmed-77960332021-01-10 Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation Lunardi, Mattia Pighi, Michele Venturi, Gabriele Del Sole, Paolo Alberto Pesarini, Gabriele Mainardi, Andrea Scarsini, Roberto Ferrero, Valeria Gottin, Leonardo Ribichini, Flavio J Clin Med Article Background. Coronary artery disease (CAD) is a common finding among patients undergoing trans-catheter aortic valve implantation (TAVI), who often present severely calcified coronary lesions. Evidence is scarce about the use of rotational atherectomy (RA) in this setting, in particular regarding long-term outcome. Methods. RA was performed on severely calcified coronary lesions concomitant with TAVI in a consecutive series of patients treated between 2010 and 2020. Immediate and long-term clinical outcomes are reported. Results. A concomitant CAD (coronary stenosis visually > 50%) was observed in 402/845 (47.6%) consecutive patients undergoing TAVI at the University Hospital of Verona. Angioplasty was performed in 104 patients (12.3%). Among these, 19 patients (18.3%, 20 coronary arteries), were treated with RA after TAVI: 10 after implantation of a balloon-expandable trans-catheter valve and 9 after a self-expandable valve. All procedures were successful. Hypotension occurred in 3 patients (15.8%), with rapid recovery after the procedure; CI-AKI (contrast-induced acute kidney injury) in 3 patients (15.8%), of which two recovered within discharge. At a median follow-up of 21.5 months (Q1–3: 6–36) event free survival was 83.3%. Only one patient suffered a target vessel failure >2 years after RA. Neither stroke nor peri-procedural infarctions were detected. Conclusions. RA concomitant with TAVI was feasible and safe in patients treated with implantation of either self-expandable, or balloon-expandable trans-catheter aortic valves. Long-term clinical events related to the coronary procedure were extremely infrequent and the survival rate at median follow-up of 21.5 months was 83.3%. MDPI 2020-12-31 /pmc/articles/PMC7796033/ /pubmed/33396185 http://dx.doi.org/10.3390/jcm10010112 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lunardi, Mattia
Pighi, Michele
Venturi, Gabriele
Del Sole, Paolo Alberto
Pesarini, Gabriele
Mainardi, Andrea
Scarsini, Roberto
Ferrero, Valeria
Gottin, Leonardo
Ribichini, Flavio
Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation
title Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation
title_full Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation
title_fullStr Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation
title_full_unstemmed Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation
title_short Short-and-Long-Term Outcomes after Coronary Rotational Atherectomy in Patients Treated with Trans-Catheter Aortic Valve Implantation
title_sort short-and-long-term outcomes after coronary rotational atherectomy in patients treated with trans-catheter aortic valve implantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796033/
https://www.ncbi.nlm.nih.gov/pubmed/33396185
http://dx.doi.org/10.3390/jcm10010112
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