Piccoli Anna, Lunardi Mattia, Ariotti Sara, Ferrero Valeria, Vassanelli Corrado, Ribichini Flavio
Division of Cardiology of the Department of Medicine, University of Verona, Verona, Italy.
Division of Cardiology of the Department of Medicine, University of Verona, Verona, Italy.
Cardiovasc Revasc Med. 2015 Jan-Feb;16(1):58-61. doi: 10.1016/j.carrev.2014.11.003. Epub 2014 Nov 20.
Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described.
老年人主动脉瓣狭窄（AVS）常与冠状动脉疾病（CAD）相关。在冠状动脉严重狭窄的患者中，外科瓣膜置换术常与冠状动脉旁路移植术同时进行，但对于接受经导管主动脉瓣植入术（TAVI）的患者是否需要进行冠状动脉血管成形术尚不清楚。鉴于老年钙化性AVS患者CAD情况常常较为复杂，某些情况下可能需要进行旋磨术（RA）。目前尚无关于TAVI期间RA可行性和安全性的数据。本文讨论了TAVI候选患者心肌血运重建的必要性，并描述了一系列TAVI期间进行RA的病例。
