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Aortic Valve Disease and Associated Complex CAD: The Interventional Approach

Federico Marin, Roberto Scarsini, Rafail A. Kotronias, Dimitrios Terentes Printzios, Matthew K. Burrage, Jonathan Bray, Jonathan L. Ciofani, Gabriele Venturi, Michele Pighi, Giovanni L. De Maria, Adrian P. Banning

Journal of Clinical Medicine, Volume: 10, Issue: 5, Start page: 946

Swansea University Author: Jonathan Bray

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DOI (Published version): 10.3390/jcm10050946

Abstract

Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary...

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Published in: Journal of Clinical Medicine
ISSN: 2077-0383
Published: MDPI AG 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa56965
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spelling 2021-06-14T16:28:20.1712670 v2 56965 2021-05-25 Aortic Valve Disease and Associated Complex CAD: The Interventional Approach c8b2c8d8ea027cdd8b0a318ab9d89f78 Jonathan Bray Jonathan Bray true false 2021-05-25 FGMHL Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary intervention (PCI) practice is yet to be determined. A major challenge is the ability to elucidate the severity of bystander coronary stenosis independently of the severity of aortic valve stenosis and subsequent impact on blood flow. The prognostic role of CAD in patients undergoing TAVI is being still debated and the benefits and the best timing of PCI in this context are currently under evaluation. Additionally, PCI in the setting of advanced AS poses some technical challenges, due to the complex anatomy, risk of hemodynamic instability, and the increased risk of bleeding complications. This review aims to provide a comprehensive synthesis of the available literature on myocardial revascularization in patients with severe AS undergoing TAVI. This work can assist the Heart Team in individualizing decisions about myocardial revascularization, taking into account available diagnostic tools as well as the risks and benefits. Journal Article Journal of Clinical Medicine 10 5 946 MDPI AG 2077-0383 aortic stenosis, coronary artery disease, myocardial revascularization, percutaneous coronary intervention 1 3 2021 2021-03-01 10.3390/jcm10050946 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2021-06-14T16:28:20.1712670 2021-05-25T15:23:09.4478199 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Federico Marin 1 Roberto Scarsini 2 Rafail A. Kotronias 3 Dimitrios Terentes Printzios 4 Matthew K. Burrage 5 Jonathan Bray 6 Jonathan L. Ciofani 7 Gabriele Venturi 8 Michele Pighi 9 Giovanni L. De Maria 10 Adrian P. Banning 11 56965__20157__b30467b47e92415686a024fe2346b29d.pdf 56965.pdf 2021-06-14T16:26:35.0125213 Output 1652939 application/pdf Version of Record true Copyright: © 2021 by the authors. This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license true eng https://creativecommons.org/licenses/by/4.0/
title Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
spellingShingle Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
Jonathan Bray
title_short Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_full Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_fullStr Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_full_unstemmed Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
title_sort Aortic Valve Disease and Associated Complex CAD: The Interventional Approach
author_id_str_mv c8b2c8d8ea027cdd8b0a318ab9d89f78
author_id_fullname_str_mv c8b2c8d8ea027cdd8b0a318ab9d89f78_***_Jonathan Bray
author Jonathan Bray
author2 Federico Marin
Roberto Scarsini
Rafail A. Kotronias
Dimitrios Terentes Printzios
Matthew K. Burrage
Jonathan Bray
Jonathan L. Ciofani
Gabriele Venturi
Michele Pighi
Giovanni L. De Maria
Adrian P. Banning
format Journal article
container_title Journal of Clinical Medicine
container_volume 10
container_issue 5
container_start_page 946
publishDate 2021
institution Swansea University
issn 2077-0383
doi_str_mv 10.3390/jcm10050946
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary intervention (PCI) practice is yet to be determined. A major challenge is the ability to elucidate the severity of bystander coronary stenosis independently of the severity of aortic valve stenosis and subsequent impact on blood flow. The prognostic role of CAD in patients undergoing TAVI is being still debated and the benefits and the best timing of PCI in this context are currently under evaluation. Additionally, PCI in the setting of advanced AS poses some technical challenges, due to the complex anatomy, risk of hemodynamic instability, and the increased risk of bleeding complications. This review aims to provide a comprehensive synthesis of the available literature on myocardial revascularization in patients with severe AS undergoing TAVI. This work can assist the Heart Team in individualizing decisions about myocardial revascularization, taking into account available diagnostic tools as well as the risks and benefits.
published_date 2021-03-01T04:12:20Z
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