How to address the coronaries in TAVI candidates: can the need for revascularization be safely determined by CT angiography only?

European heart journal. Imaging methods and practice Pub Date : 2024-10-28 eCollection Date: 2024-04-01 DOI:10.1093/ehjimp/qyae096
Katharina Theresa Julia Mascherbauer, Gudrun Lamm, Andreas Anselm Kammerlander, Maximilian Will, Christian Nitsche, Roya Anahita Mousavi, Caglayan Demirel, Philipp Emanuel Bartko, Konstantin Schwarz, Christian Hengstenberg, Julia Mascherbauer
{"title":"How to address the coronaries in TAVI candidates: can the need for revascularization be safely determined by CT angiography only?","authors":"Katharina Theresa Julia Mascherbauer, Gudrun Lamm, Andreas Anselm Kammerlander, Maximilian Will, Christian Nitsche, Roya Anahita Mousavi, Caglayan Demirel, Philipp Emanuel Bartko, Konstantin Schwarz, Christian Hengstenberg, Julia Mascherbauer","doi":"10.1093/ehjimp/qyae096","DOIUrl":null,"url":null,"abstract":"<p><p>Coronary artery disease (CAD) remains one of the most frequent comorbidities among transcatheter aortic valve implantation (TAVI) candidates. Whether routine assessment of CAD by invasive coronary angiography (CA) and eventual peri-procedural percutaneous coronary intervention (PCI) is generally beneficial in TAVI patients has recently been heavily questioned. CA carries significant risks, such as kidney injury, bleeding, and prolonged hospital stay, and may frequently be unnecessary if significant stenoses of the proximal coronary segments can be ruled out on computed tomography angiography. Moreover, the benefits of pre-emptive coronary revascularization at the time of TAVI are not well defined. Despite these facts and weak guideline recommendations, CA and eventual PCI of stable significant coronary lesions at the time of TAVI remain common practice. However, ongoing randomized trials currently challenge the efficacy of such strategies to enable a more streamlined, individualized, and resource-sparing treatment with TAVI.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518922/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European heart journal. Imaging methods and practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjimp/qyae096","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Coronary artery disease (CAD) remains one of the most frequent comorbidities among transcatheter aortic valve implantation (TAVI) candidates. Whether routine assessment of CAD by invasive coronary angiography (CA) and eventual peri-procedural percutaneous coronary intervention (PCI) is generally beneficial in TAVI patients has recently been heavily questioned. CA carries significant risks, such as kidney injury, bleeding, and prolonged hospital stay, and may frequently be unnecessary if significant stenoses of the proximal coronary segments can be ruled out on computed tomography angiography. Moreover, the benefits of pre-emptive coronary revascularization at the time of TAVI are not well defined. Despite these facts and weak guideline recommendations, CA and eventual PCI of stable significant coronary lesions at the time of TAVI remain common practice. However, ongoing randomized trials currently challenge the efficacy of such strategies to enable a more streamlined, individualized, and resource-sparing treatment with TAVI.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
如何处理 TAVI 候选者的冠状动脉:仅通过 CT 血管造影能否安全地确定是否需要进行血管再通术?
冠状动脉疾病(CAD)仍然是经导管主动脉瓣植入术(TAVI)患者最常见的合并症之一。通过有创冠状动脉造影术(CA)对冠状动脉疾病进行常规评估并最终进行围手术期经皮冠状动脉介入治疗(PCI)是否对经导管主动脉瓣植入术(TAVI)患者有普遍益处,近来备受质疑。冠状动脉造影有很大的风险,如肾损伤、出血和住院时间延长,而且如果通过计算机断层扫描血管造影可以排除冠状动脉近端明显狭窄,那么冠状动脉造影往往是不必要的。此外,在进行 TAVI 时预先进行冠状动脉血运重建的益处尚未明确。尽管存在这些事实,且指南建议不充分,但在进行 TAVI 时对稳定的重要冠状动脉病变进行 CA 和最终 PCI 仍是常见的做法。然而,目前正在进行的随机试验对这些策略的疗效提出了质疑,这些策略可使 TAVI 治疗更加简化、个体化和节省资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
How to address the coronaries in TAVI candidates: can the need for revascularization be safely determined by CT angiography only? Feasibility validation of automatic diagnosis of mitral valve prolapse from multi-view echocardiographic sequences based on deep neural network. Deep learning improves test-retest reproducibility of regional strain in echocardiography. HoloPatch: improving intracardiac patch fit through holographically modelled templates. Issue at a glance.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1