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Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation

BACKGROUND: Performing selective coronary angiogram (CA) and percutaneous coronary intervention (PCI) post transcatheter aortic valve implantation (TAVI) may be challenging with various success rates of coronary ostia engagement. METHODS: Among all patients who underwent CA and/or PCI after TAVI fro...

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Autores principales: Perrin, Nils, Fassa, Amir, Baroz, Antoine, Frangos, Caroline, Mock, Stephane, Frei, Angela, Cimci, Murat, Degrauwe, Sophie, Roffi, Marco, Iglesias, Juan Fernando, Noble, Stephane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007485/
https://www.ncbi.nlm.nih.gov/pubmed/32436588
http://dx.doi.org/10.5603/CJ.a2020.0073
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author Perrin, Nils
Fassa, Amir
Baroz, Antoine
Frangos, Caroline
Mock, Stephane
Frei, Angela
Cimci, Murat
Degrauwe, Sophie
Roffi, Marco
Iglesias, Juan Fernando
Noble, Stephane
author_facet Perrin, Nils
Fassa, Amir
Baroz, Antoine
Frangos, Caroline
Mock, Stephane
Frei, Angela
Cimci, Murat
Degrauwe, Sophie
Roffi, Marco
Iglesias, Juan Fernando
Noble, Stephane
author_sort Perrin, Nils
collection PubMed
description BACKGROUND: Performing selective coronary angiogram (CA) and percutaneous coronary intervention (PCI) post transcatheter aortic valve implantation (TAVI) may be challenging with various success rates of coronary ostia engagement. METHODS: Among all patients who underwent CA and/or PCI after TAVI from our single center TAVI registry, ostia cannulation success was reported according to the quality of ostia engagement and artery opacification, and was classified as either selective, partially selective or non-selective but sufficient for diagnosis. RESULTS: Among the 424 consecutive TAVI procedures performed at the aforementioned institution, 20 (4.7%) CA were performed in 19 (4.5%) patients at a median time of 464 days post TAVI (25–75% IQ: 213–634 days). CA were performed in 7 CoreValve, 9 Evolut R, 1 Evolut PRO and 2 Edwards Sapien 3 devices. Transradial vascular approach was attempted in 9 procedures (45%, right n = 6 and left n = 3) and was successful in 8 (40%) patients. A total of 20 left main artery ostium cannulation were attempted leading to a diagnostic CA in all of them with selective engagement in 65%. Engagement of the right coronary artery in 2 out of 15 attempted cases failed due to a low ostium in conjunction with a high implantation of a CoreValve prosthesis. 11 PCI (55% of CA) including 2 left main lesions were performed. In 4 patients (36.4% of the PCI), an extension catheter was required to engage the left main. All planned PCI were successful. CONCLUSIONS: Post TAVI CA and PCI are challenging but feasible even after supra-annular self-expandable valve implantation.
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spelling pubmed-90074852022-04-14 Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation Perrin, Nils Fassa, Amir Baroz, Antoine Frangos, Caroline Mock, Stephane Frei, Angela Cimci, Murat Degrauwe, Sophie Roffi, Marco Iglesias, Juan Fernando Noble, Stephane Cardiol J Interventional Cardiology BACKGROUND: Performing selective coronary angiogram (CA) and percutaneous coronary intervention (PCI) post transcatheter aortic valve implantation (TAVI) may be challenging with various success rates of coronary ostia engagement. METHODS: Among all patients who underwent CA and/or PCI after TAVI from our single center TAVI registry, ostia cannulation success was reported according to the quality of ostia engagement and artery opacification, and was classified as either selective, partially selective or non-selective but sufficient for diagnosis. RESULTS: Among the 424 consecutive TAVI procedures performed at the aforementioned institution, 20 (4.7%) CA were performed in 19 (4.5%) patients at a median time of 464 days post TAVI (25–75% IQ: 213–634 days). CA were performed in 7 CoreValve, 9 Evolut R, 1 Evolut PRO and 2 Edwards Sapien 3 devices. Transradial vascular approach was attempted in 9 procedures (45%, right n = 6 and left n = 3) and was successful in 8 (40%) patients. A total of 20 left main artery ostium cannulation were attempted leading to a diagnostic CA in all of them with selective engagement in 65%. Engagement of the right coronary artery in 2 out of 15 attempted cases failed due to a low ostium in conjunction with a high implantation of a CoreValve prosthesis. 11 PCI (55% of CA) including 2 left main lesions were performed. In 4 patients (36.4% of the PCI), an extension catheter was required to engage the left main. All planned PCI were successful. CONCLUSIONS: Post TAVI CA and PCI are challenging but feasible even after supra-annular self-expandable valve implantation. Via Medica 2022-04-07 /pmc/articles/PMC9007485/ /pubmed/32436588 http://dx.doi.org/10.5603/CJ.a2020.0073 Text en Copyright © 2022 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Interventional Cardiology
Perrin, Nils
Fassa, Amir
Baroz, Antoine
Frangos, Caroline
Mock, Stephane
Frei, Angela
Cimci, Murat
Degrauwe, Sophie
Roffi, Marco
Iglesias, Juan Fernando
Noble, Stephane
Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation
title Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation
title_full Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation
title_fullStr Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation
title_full_unstemmed Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation
title_short Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation
title_sort complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation
topic Interventional Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007485/
https://www.ncbi.nlm.nih.gov/pubmed/32436588
http://dx.doi.org/10.5603/CJ.a2020.0073
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