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Aortic Valve Disease and Associated Complex CAD: The Interventional Approach

Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary...

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Autores principales: Marin, Federico, Scarsini, Roberto, Kotronias, Rafail A., Printzios, Dimitrios Terentes, Burrage, Matthew K., Bray, Jonathan J. H., Ciofani, Jonathan L., Venturi, Gabriele, Pighi, Michele, De Maria, Giovanni L., Banning, Adrian P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957505/
https://www.ncbi.nlm.nih.gov/pubmed/33804391
http://dx.doi.org/10.3390/jcm10050946
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author Marin, Federico
Scarsini, Roberto
Kotronias, Rafail A.
Printzios, Dimitrios Terentes
Burrage, Matthew K.
Bray, Jonathan J. H.
Ciofani, Jonathan L.
Venturi, Gabriele
Pighi, Michele
De Maria, Giovanni L.
Banning, Adrian P.
author_facet Marin, Federico
Scarsini, Roberto
Kotronias, Rafail A.
Printzios, Dimitrios Terentes
Burrage, Matthew K.
Bray, Jonathan J. H.
Ciofani, Jonathan L.
Venturi, Gabriele
Pighi, Michele
De Maria, Giovanni L.
Banning, Adrian P.
author_sort Marin, Federico
collection PubMed
description Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary intervention (PCI) practice is yet to be determined. A major challenge is the ability to elucidate the severity of bystander coronary stenosis independently of the severity of aortic valve stenosis and subsequent impact on blood flow. The prognostic role of CAD in patients undergoing TAVI is being still debated and the benefits and the best timing of PCI in this context are currently under evaluation. Additionally, PCI in the setting of advanced AS poses some technical challenges, due to the complex anatomy, risk of hemodynamic instability, and the increased risk of bleeding complications. This review aims to provide a comprehensive synthesis of the available literature on myocardial revascularization in patients with severe AS undergoing TAVI. This work can assist the Heart Team in individualizing decisions about myocardial revascularization, taking into account available diagnostic tools as well as the risks and benefits.
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spelling pubmed-79575052021-03-16 Aortic Valve Disease and Associated Complex CAD: The Interventional Approach Marin, Federico Scarsini, Roberto Kotronias, Rafail A. Printzios, Dimitrios Terentes Burrage, Matthew K. Bray, Jonathan J. H. Ciofani, Jonathan L. Venturi, Gabriele Pighi, Michele De Maria, Giovanni L. Banning, Adrian P. J Clin Med Review Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary intervention (PCI) practice is yet to be determined. A major challenge is the ability to elucidate the severity of bystander coronary stenosis independently of the severity of aortic valve stenosis and subsequent impact on blood flow. The prognostic role of CAD in patients undergoing TAVI is being still debated and the benefits and the best timing of PCI in this context are currently under evaluation. Additionally, PCI in the setting of advanced AS poses some technical challenges, due to the complex anatomy, risk of hemodynamic instability, and the increased risk of bleeding complications. This review aims to provide a comprehensive synthesis of the available literature on myocardial revascularization in patients with severe AS undergoing TAVI. This work can assist the Heart Team in individualizing decisions about myocardial revascularization, taking into account available diagnostic tools as well as the risks and benefits. MDPI 2021-03-01 /pmc/articles/PMC7957505/ /pubmed/33804391 http://dx.doi.org/10.3390/jcm10050946 Text en © 2021 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 Review
Marin, Federico
Scarsini, Roberto
Kotronias, Rafail A.
Printzios, Dimitrios Terentes
Burrage, Matthew K.
Bray, Jonathan J. H.
Ciofani, Jonathan L.
Venturi, Gabriele
Pighi, Michele
De Maria, Giovanni L.
Banning, Adrian P.
Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_full Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_fullStr Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_full_unstemmed Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_short Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_sort aortic valve disease and associated complex cad: the interventional approach
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957505/
https://www.ncbi.nlm.nih.gov/pubmed/33804391
http://dx.doi.org/10.3390/jcm10050946
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