Publications

Authors:

Zivelonghi, Carlo; Lunardi, Mattia; Pesarini, Gabriele; Scarsini, Roberto; Piccoli, Anna; Ferrero, Valeria; Gottin, Leonardo; Milano, Aldo; Faggian, Giuseppe; Vassanelli, Corrado; Ribichini, Flavio

Title:

Coronary artery disease in patients undergoing transcatheter aortic valve implantation. A single centre registry on prevalence, management and immediate clinical impact

Year:

2017

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Vasa

ISSN of journal:

0010-8650

N° Volume:

59

Number or Folder:

1

Page numbers:

e23-e28

Keyword:

Aortic valve stenosis; Trans-catheter aortic valve implantation (TAVI); Coronary angiography; Myocardial revascularization

Short description of contents:

Introduction: Prevalence of coronary artery disease (CAD) ranges from 30% to 60% of all patients with aortic valve stenosis (AVS). At present, little is known about the best management of CAD in patients undergoing trans-catheter aortic valve implantation (TAVI). Aim of this study is to investigate the prevalence, management and the immediate clinical impact of CAD in this population, with a special focus on the feasibility and safety of a physiologically-guided revascularization strategy.Methods and results: A total of 287 consecutive patients undergoing TAVI in our center were retrospectively included in the analysis. Those presenting CAD (123, 43%) were divided in three groups, according to the therapeutic strategy adopted by the operator: optimal medical therapy group (42 out of 123, 34%), preventive-PCI for angiographically significant coronary lesions (34 out of 123, 28%) and a physiologically-guided strategy (47 out of 123, 38%). The mean Logistic EuroSCORE was 31 +/- 24% in the CAD population, with a higher risk profile in medical therapy group. TAVI procedural success in the overall population was 96%. Thirty-day clinical outcome showed a higher incidence of MACEs in the optimal medical therapy and the preventive PCI group (11.9% and 5.9% respectively), with no occurrence of adverse events in the FFR-guided group.Conclusions: The best management of CAD in TAVI is still under investigation. Despite a relatively limited sample size, our findings demonstrate the feasibility and safety of a physiologically-guided revascularization strategy. Larger trials are needed to confirm our observations and to assess the long-term clinical impact. (C) 2017 The Czech Society of Cardiology. Published by Elsevier Sp. z o.o. All rights reserved.

Product ID:

118604

Handle IRIS:

11562/1032988

Last Modified:

November 15, 2022

Bibliographic citation:

Zivelonghi, Carlo; Lunardi, Mattia; Pesarini, Gabriele; Scarsini, Roberto; Piccoli, Anna; Ferrero, Valeria; Gottin, Leonardo; Milano, Aldo; Faggian, Giuseppe; Vassanelli, Corrado; Ribichini, Flavio, Coronary artery disease in patients undergoing transcatheter aortic valve implantation. A single centre registry on prevalence, management and immediate clinical impact «Vasa» , vol. 59 , n. 1 , 2017 , pp. e23-e28

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