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      Coronary Artery Disease and Revascularization in Patients Undergoing Transcatheter Aortic Valve Replacement

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          Abstract

          Coronary artery disease (CAD) and aortic stenosis share similar risk factors and underlying pathophysiology. Up to half of the patient population undergoing work-up for aortic valve replacement have underlying CAD, which can affect outcomes in patients with more severe disease. As the indications for transcatheter aortic valve replacement (TAVR) have expanded to intermediate and now low risk patients, the optimal management of CAD in this patient population still needs to be determined. This includes both pre-TAVR evaluation for CAD as well as indications for revascularization in patients undergoing TAVR. There is also limited data on coronary interventions after TAVR, including the incidence, feasibility and outcomes of patients undergoing percutaneous coronary intervention (PCI) after TAVR. This review provides an updated report of the current literature on CAD in TAVR patients, focusing on its prevalence, impact on outcomes, timing of revascularization and potential challenges with coronary interventions post-TAVR.

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          Most cited references76

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          Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients

          Among patients with aortic stenosis who are at intermediate or high risk for death with surgery, major outcomes are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. There is insufficient evidence regarding the comparison of the two procedures in patients who are at low risk.
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            Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients

            Transcatheter aortic-valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis who are at increased risk for death from surgery; less is known about TAVR in low-risk patients.
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              Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients.

              Previous trials have shown that among high-risk patients with aortic stenosis, survival rates are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. We evaluated the two procedures in a randomized trial involving intermediate-risk patients.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Rev Cardiovasc Med
                RCM
                Reviews in Cardiovascular Medicine
                IMR Press
                2153-8174
                1530-6550
                22 August 2022
                September 2022
                : 23
                : 9
                : 290
                Affiliations
                [1] 1Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
                [2] 2Division of Cardiology, Tucson Medical Center, Tucson, AZ 85712, USA
                Author notes
                *Correspondence: jabbott@ 123456lifespan.org (J. Dawn Abbott)

                These authors contributed equally.

                Article
                S1530-6550(22)00653-6
                10.31083/j.rcm2309290
                11262379
                39077700
                a524ef2d-64a3-498b-85f6-e2fcd8efff50
                Copyright: © 2022 The Author(s). Published by IMR Press.

                This is an open access article under the CC BY 4.0 license.

                History
                : 14 April 2022
                : 18 July 2022
                : 1 August 2022
                Categories
                Review

                aortic stenosis,coronary artery disease,percutaneous coronary intervention,transcatheter aortic valve replacement

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