Severe Aortic Stenosis and Coronary Artery Diseased Implications for Management in the Transcatheter Aortic Valve Replacement Era A Comprehensive Review

被引：216

作者：

Goel, Sachin S. ^{[1
]}

Ige, Mobolaji ^{[2
]}

Tuzcu, E. Murat ^{[1
]}

Ellis, Stephen G. ^{[1
]}

Stewart, William J. ^{[1
]}

Svensson, Lars G. ^{[3
]}

Lytle, Bruce W. ^{[3
]}

Kapadia, Samir R. ^{[1
]}

机构：

[1] Cleveland Clin Fdn, Dept Cardiovasc Med, Cleveland, OH 44195 USA

[2] Cleveland Clin Fdn, Dept Hosp Med, Cleveland, OH 44195 USA

[3] Cleveland Clin Fdn, Dept Cardiothorac Surg, Cleveland, OH 44195 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2013年 / 62卷 / 01期

关键词：

aortic stenosis; coronary artery disease; surgical aortic valve replacement; transcatheter aortic valve replacement; HIGH-RISK PATIENTS; IN-HOSPITAL MORTALITY; END-POINT DEFINITIONS; PROGNOSTIC VALUE; SURGICAL RISK; LATE OUTCOMES; IMPLANTATION; INTERVENTION; COREVALVE; PREVALENCE;

D O I：

10.1016/j.jacc.2013.01.096

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Management of coronary artery disease (CAD) in patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) is posing challenges. Due to limited and heterogeneous data on the prevalence and clinical impact of CAD on the outcomes of TAVR and the management strategies for CAD in patients undergoing TAVR, we performed a comprehensive review of the literature. Significant CAD is present in 40% to 75% of patients undergoing TAVR. The impact of CAD on outcomes after TAVR remains understudied. Based on existing data, not all patients require revascularization before TAVR. Percutaneous coronary intervention (PCI) should be considered for severely stenotic lesions in proximal coronaries that subtend a large area of myocardium at risk. Ongoing studies randomizing patients to surgical or percutaneous management strategies for severe AS will help provide valuable data regarding the impact of CAD on TAVR outcomes, the role of PCI, and its timing in relation to TAVR. (C) 2013 by the American College of Cardiology Foundation

引用

页码：1 / 10

页数：10

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