Coronary artery disease and reasonably incomplete coronary revascularization in high‐risk patients undergoing transcatheter aortic valve implantation

2019 ◽  
Vol 95 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Francesco Saia ◽  
Tullio Palmerini ◽  
Miriam Compagnone ◽  
Paola Battistini ◽  
Carolina Moretti ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Valve ◽  
Coronary Revascularization ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Aortic Valve Implantation ◽  
Artery Disease ◽  
Valve Implantation

Transaortic Transcatheter Aortic Valve Implantation and Concomitant off Pump Revascularization

2016 ◽  
Vol 11 (5) ◽  
pp. 363-366 ◽  
Author(s):  
Hardy Baumbach ◽  
Samir Ahad ◽  
Stephan Hill ◽  
Tim Schäufele ◽  
Sara Adili ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Revascularization ◽  
Off Pump ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Aortic Valve Implantation ◽  
Artery Disease ◽  
Valve Implantation

An increasing number of patients with severe aortic stenosis and concomitant critical coronary artery disease were referred to our hospital. Some of those patients were classified as high-risk patients qualifying for a transcatheter therapy with the additional need for coronary revascularization. As a consequence of their comorbidities, the established transapical as well as transfemoral approach were either not possible or not favored owing to the indispensable need for coronary revascularization. We present 4 successfully combined off-pump procedures consisting of a transcatheter aortic valve implantation (Edwards SAPIEN XT) via the transaortic approach and an off-pump coronary artery bypass grafting. All patients were discharged free from stroke, myocardial infarction, or access site complications either to rehabilitation facility or to the referring hospital with none or trace aortic regurgitation and patent grafts. These cases confirm the feasibility of those combined operations and should be considered as realistic alternative for surgical treatment in high-risk patients who are clearly identified to benefit from transcatheter approach to treat aortic stenosis and who have severe concomitant coronary artery disease.

Transcatheter aortic valve implantation and the management of coronary artery disease

2018 ◽  
pp. 600-606
Author(s):  
Muhammed Zeeshan Khawaja ◽  
Simon Redwood
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Aortic Valve Implantation ◽  
Artery Disease ◽  
Valve Implantation

The advent of transcatheter aortic valve implantation (TAVI) has provoked a paradigm shift in the treatment of senile calcific aortic stenosis (AS), the most common valvular disease in the developed world. Its benefits in high-risk and inoperable patients and its comparable outcomes to surgical aortic valve replacement are well established, and there is now evidence supporting use of the technique in intermediate-risk patients. AS often coexists with coronary artery disease (CAD) and, in seeking to further improve outcomes and minimize risks in the TAVI procedure, the management of concomitant CAD is an important consideration.

scholarly journals Use of extracorporeal membrane oxygenation as a bridge to transcatheter aortic valve replacement in a patient with aortic stenosis and severe coronary artery disease: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Majid Ahsan ◽  
Rolf Alexander Jánosi ◽  
Tienush Rassaf ◽  
Alexander Lind
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Artery Disease

Abstract Background Patients with severe aortic stenosis (AS) often present with multiple comorbidities and suffer from critical coronary artery disease (CAD). Transcatheter aortic valve replacement (TAVR) has become the therapy of choice for moderate to high-risk patients. Venoarterial extracorporeal membrane oxygenation (v-a-ECMO) offers the possibility of temporary cardiac support to manage life-threatening critical situations. Case summary Here, we describe the management of a patient with severe AS and CAD with impaired left ventricular ejection fraction (LVEF). We used v-a-ECMO as an emergency strategy in cardiogenic shock during a high-risk coronary intervention to stabilize the patient, and as a further bridge to TAVR. Discussion Very high-risk patients with severe AS are unlikely to tolerate the added risk of surgical aortic valve replacement. Using ECMO may help them to benefit from TAVR as the only treatment option available.

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