Invasive Functional Assessment of Coronary Artery Disease in Patients with Severe Aortic Stenosis in the TAVI Era.

TAVI coronary angiography coronary artery disease coronary flow reserve fractional flow reserve

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
21 Aug 2023
Historique:
received: 18 07 2023
revised: 14 08 2023
accepted: 19 08 2023
medline: 26 8 2023
pubmed: 26 8 2023
entrez: 26 8 2023
Statut: epublish

Résumé

Coronary artery disease (CAD) is a common finding in patients suffering from aortic valve stenosis (AS), with a prevalence of over 50% in patients 70 years of age or older. Transcatheter aortic valve intervention (TAVI) is the standard treatment option for patients with severe AS and at least 75 years of age. Current guidelines recommend percutaneous coronary intervention (PCI) in patients planned for TAVI with stenoses of >70% in the proximal segments of non-left main coronary arteries and in >50% of left main stenoses. While the guidelines on myocardial revascularization clearly recommend functional assessment of coronary artery stenoses of less than 90% in the absence of non-invasive ischemia testing, a statement regarding invasive functional testing in AS patients with concomitant CAD is lacking in the recently published guideline on the management of valvular heart disease. This review aims to provide an overview of the hemodynamic background in AS patients, discusses and summarizes the current evidence of invasive functional testing in patients with severe AS, and gives a future perspective on the ongoing trials on that topic.

Identifiants

pubmed: 37629456
pii: jcm12165414
doi: 10.3390/jcm12165414
pmc: PMC10455333
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

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Auteurs

Maren Weferling (M)

Department of Cardiology, Kerckhoff Heart and Thorax Center, 61231 Bad Nauheim, Germany.
German Center for Cardiovascular Research (DZHK), Partnersite Rhein-Main, 10785 Berlin, Germany.

Won-Keun Kim (WK)

Department of Cardiology, Kerckhoff Heart and Thorax Center, 61231 Bad Nauheim, Germany.
German Center for Cardiovascular Research (DZHK), Partnersite Rhein-Main, 10785 Berlin, Germany.
Department of Cardio-Thoracic Surgery, Kerckhoff Heart and Thorax Center, 61231 Bad Nauheim, Germany.

Classifications MeSH