scholarly journals Management of concomitant coronary artery disease and aortic valve stenosis in the era of transcatheter aortic valve treatment

2022 ◽  
Author(s):  
Stefano Cangemi ◽  
Cristina Aurigemma ◽  
Enrico Romagnoli ◽  
Francesco Bianchini ◽  
Piergiorgio Bruno ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Current Knowledge ◽  
Considerable Uncertainty ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Artery Disease ◽  
Concomitant Coronary Artery Disease ◽  
Valve Implantation

Severe calcific aortic stenosis (AS) and coronary artery disease (CAD) have common risk factors and are frequently encountered in the same patient in clinical practice. CAD has been reported in ≥ 50% of AS patients undergoing both surgical treatment and transcatheter aortic valve implantation (TAVI). In the last two decades, TAVI has been established as a less invasive alternative to surgery. Recently, more and more young and low surgical risk patients undergo TAVI. Despite the high prevalence of CAD in patients treated with TAVI, the management strategy of concomitant CAD in these patients remains an area of considerable uncertainty. This review provides an updated overview of the current knowledge about this topic and offers points for reflection about the best approach to use.

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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