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Publications

Journal Article Review Epublish

PubMed: 42219978 DOI: 10.4244/EIJ-D-25-00874

TAVI and coronary interventions: indications, technical considerations, and clinical scenarios.

EuroIntervention 22(11):e603-e616

Authors: Heberto Aquino Bruno, Ole De Backer, Gilbert H L Tang, Ignacio J Amat-Santos, Jacob Lønborg, Didier Tchetche, Marco Barbanti, Juan F García-García, Juan C Plata-Corona, Juan C Fuentes-Moreno, Jose R Gayosso-Ortiz, Hiram Vela-Vizcaino, Marco A Alcántara-Meléndez, Ander Regueiro, Nicolo Piazza, Giuseppe Tarantini

Affiliations

  • Interventional Cardiology Department, Hospital General de Mexico Dr. Eduardo Liceaga, Mexico City, Mexico.
  • The Heart Center, Rigshospitalet, Copenhagen, Denmark.
  • Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY, USA.
  • Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain and Interventional Cardiology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Groupe Cardiovasculaire Interventionnel, Clinique Pasteur, Toulouse, France.
  • Division of Cardiology, A.O.U. Policlinico G. Rodolico-San Marco, Catania, Italy.
  • Interventional Cardiology Department, Hospital Universitario de Puebla, Puebla, Mexico.
  • Interventional Cardiology Department, Centro Médico Nacional 20 de Noviembre, ISSSTE, Mexico City, Mexico.
  • Department of Cardiology, Hospital Clinic, University of Barcelona, Barcelona, Spain.
  • Division of Cardiology, Department of Medicine, McGill University, Montreal, Canada.
  • Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy.

Abstract

Transcatheter aortic valve implantation (TAVI) has become the preferred treatment for severe aortic stenosis. Nonetheless, interplay between aortic valve disease, transcatheter valve implantation, and the coronary arteries is frequent and clinically relevant. Coronary intervention in the context of TAVI encompasses distinct but interrelated scenarios, including the management of concomitant coronary artery disease and the prevention or treatment of coronary artery obstruction. These aspects introduce additional complexity to procedural planning and long-term management. This review provides a comprehensive and practical overview of coronary interventions related to TAVI, encompassing coronary evaluation and physiological assessment, the indications and timing of percutaneous coronary intervention before and after valve implantation, and strategies for managing coronary obstruction. Particular emphasis is placed on anatomical and device-related factors influencing coronary access, including transcatheter heart valve design, aortic root anatomy, and commissural alignment. By structuring coronary interventions according to distinct clinical scenarios, this article aims to support tailored decision-making and optimise procedural safety, feasibility, and long-term coronary management in patients undergoing TAVI.

MeSH

Arteries, Aortic Valve, Transcatheter Aortic Valve Replacement, Therapeutics