Expert consensus on the management of coronary artery disease in patients with arotic stenosis undergoing transcatheter aortic valve implantation

Abstract

Aortic stenosis (AS) combined with coronary artery disease (CAD) is very common in clinical practice. Transcatheter aortic valve implantation (TAVI) is an effective clinical treatment for AS. Due to the advantages of less trauma and faster recovery, the clinical application of TAVI has become more and more extensive. However, after TAVI, coronary angiography and percutaneous coronary intervention (PCI) may become difficult due to the valve frame or the patients valve. Meanwhile, acute occlusion of the coronary arteries may be caused during TAVI with severe consequences in a small number of patients because of the structures surrounding the aortic valve and coronary artery openings. Clinically, the management of CAD in patients undergoing TAVI has not been taken seriously. In addition, treatment evidence and recommendations are not uniform. Therefore, this consensus analyzes and reviews the evidence on the impact of CAD on the prognosis of patients undergoing TAVI, the implementation of PCI in patients undergoing TAVI, and the conduct of coronary artery protective measures during TAVI, with the aim of providing valuable recommendations for clinical practice.

Keywords

• aortic stenosis
• coronary artery disease
• transcatheter aortic valve implantation
• percutaneous coronary intervention
• instantaneous wave-free ratio