经导管主动脉瓣植入术候选患者的冠状动脉血运重建：为何、何人、何时？
Coronary Revascularisation in Transcatheter Aortic Valve Implantation Candidates: Why, Who, When?
作者信息
Cao Davide, Chiarito Mauro, Pagnotta Paolo, Reimers Bernhard, Stefanini Giulio G
机构信息
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan Italy.
Cardio Center, Humanitas Research Hospital, Rozzano-Milan Italy.
出版信息
Interv Cardiol. 2018 May;13(2):69-76. doi: 10.15420/icr.2018:2:2.
Abstract
Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist. The presence of CAD has been consistently associated with an impaired prognosis in patients undergoing surgical aortic valve replacement during short- and long-term follow-up. Accordingly, current guidelines recommend coronary revascularisation of all significant stenoses in patients undergoing surgical aortic valve replacement. Conversely, the management of concomitant CAD in patients with severe AS undergoing transcatheter aortic valve implantation (TAVI) is still a matter of debate. The aim of this review article is to provide an overview on the role of coronary revascularisation in TAVI patients.
摘要
冠状动脉疾病（CAD）和主动脉瓣狭窄（AS）常同时存在。在接受外科主动脉瓣置换术的患者短期和长期随访中，CAD的存在一直与预后不良相关。因此，当前指南建议对接受外科主动脉瓣置换术的患者中所有显著狭窄进行冠状动脉血运重建。相反，在接受经导管主动脉瓣植入术（TAVI）的重度AS患者中，合并CAD的管理仍存在争议。这篇综述文章的目的是概述冠状动脉血运重建在TAVI患者中的作用。
相似文献
1
Coronary Revascularisation in Transcatheter Aortic Valve Implantation Candidates: Why, Who, When?经导管主动脉瓣植入术候选患者的冠状动脉血运重建：为何、何人、何时？
Interv Cardiol. 2018 May;13(2):69-76. doi: 10.15420/icr.2018:2:2.
2
Impact of coronary artery disease and percutaneous coronary intervention on outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation.冠心病和经皮冠状动脉介入治疗对行经导管主动脉瓣植入术的重度主动脉瓣狭窄患者结局的影响。
EuroIntervention. 2011 Sep;7(5):541-8. doi: 10.4244/EIJV7I5A89.
3
Coronary artery disease in patients undergoing TAVI: why, what, when and how to treat.接受经导管主动脉瓣植入术患者的冠状动脉疾病：为何、是什么、何时以及如何治疗。
EuroIntervention. 2014 Sep;10 Suppl U:U69-75. doi: 10.4244/EIJV10SUA10.
4
Transcatheter aortic valve implantation combined with elective coronary artery stenting: a simultaneous approach†.经导管主动脉瓣植入术联合择期冠状动脉支架置入术：一种同步治疗方法†
Eur J Cardiothorac Surg. 2015 Jun;47(6):1083-9. doi: 10.1093/ejcts/ezu339. Epub 2014 Sep 12.
5
Complete revascularization is not a prerequisite for success in current transcatheter aortic valve implantation practice.在当前经导管主动脉瓣植入术实践中，完全血运重建并不是成功的必要条件。
JACC Cardiovasc Interv. 2013 Aug;6(8):867-75. doi: 10.1016/j.jcin.2013.04.015. Epub 2013 Jul 17.
6
Concomitant coronary artery disease and its management in patients referred to transcatheter aortic valve implantation: Insights from the POL-TAVI Registry.经导管主动脉瓣植入术患者的合并冠状动脉疾病及其管理：来自POL-TAVI注册研究的见解
Catheter Cardiovasc Interv. 2018 Jan 1;91(1):115-123. doi: 10.1002/ccd.27251. Epub 2017 Aug 26.
7
[Management of asymptomatic coronary artery disease in patients undergoing transcatheter aortic valve implantation].[经导管主动脉瓣植入术患者无症状性冠状动脉疾病的管理]
G Ital Cardiol (Rome). 2021 Jan;22(1):53-61. doi: 10.1714/3502.34883.
8
Evaluation and management of coronary artery disease in transcatheter aortic valve implantation candidates with severe aortic stenosis and coronary artery disease: technology and techniques.经导管主动脉瓣植入术候选患者严重主动脉瓣狭窄合并冠状动脉疾病的评估与管理：技术与技巧。
Expert Rev Med Devices. 2024 Oct;21(10):915-925. doi: 10.1080/17434440.2024.2401492. Epub 2024 Sep 13.
9
Coronary revascularization and TAVI: before, during, after or never?冠状动脉血运重建与经导管主动脉瓣植入术：术前、术中、术后还是不做？
Minerva Med. 2014 Dec;105(6):475-85. Epub 2014 Oct 2.
10
Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease: A comparative analysis from the Italian OBSERVANT study.经导管或手术治疗严重主动脉瓣狭窄合并冠状动脉疾病：来自意大利 OBSERVANT 研究的对比分析。
Int J Cardiol. 2018 Nov 1;270:102-106. doi: 10.1016/j.ijcard.2018.06.011. Epub 2018 Jun 7.
引用本文的文献
1
Transcatheter Aortic Valve Implantation in Cardiogenic Shock: Current Evidence, Clinical Challenges, and Future Directions.心源性休克中的经导管主动脉瓣植入术：当前证据、临床挑战及未来方向
J Clin Med. 2025 Jul 31;14(15):5398. doi: 10.3390/jcm14155398.
2
Co-Occurrence of Aortic Stenosis and Coronary Artery Disease: Facing Challenges Before, During, and After Transcatheter Aortic Valve Replacement.主动脉瓣狭窄与冠状动脉疾病的共病：经导管主动脉瓣置换术前、术中和术后面临的挑战
J Clin Med. 2025 Jul 3;14(13):4709. doi: 10.3390/jcm14134709.
3
TAVI PATIENT WITH RCA DISSECTION, POST-TAVR HIGH DEGREE AV BLOCK AND ACUTE NEUROLOGICAL INJURY.经导管主动脉瓣置入术患者合并右冠状动脉夹层、术后高度房室传导阻滞及急性神经损伤
Acta Clin Croat. 2024 Mar;63(Suppl1):111-115. doi: 10.20471/acc.2024.63.s1.21.
4
The prognostic value of preoperative CAD-RADS classification in patients undergoing isolated aortic valve surgery.术前CAD-RADS分类对接受单纯主动脉瓣手术患者的预后价值。
Int J Cardiovasc Imaging. 2025 Apr;41(4):709-720. doi: 10.1007/s10554-025-03358-1. Epub 2025 Feb 24.
5
Comparative Analysis of PCI Strategies in Aortic Stenosis Patients Undergoing TAVI: A Systematic Review and Network Meta-Analysis.经 TAVI 治疗的主动脉瓣狭窄患者行 PCI 策略的对比分析：系统评价和网络荟萃分析。
Clin Cardiol. 2024 Aug;47(8):e24324. doi: 10.1002/clc.24324.
6
The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis.经导管主动脉瓣置换术患者中合并慢性完全闭塞对临床结局的影响：一项大型单中心分析
Front Cardiovasc Med. 2024 Feb 23;11:1338253. doi: 10.3389/fcvm.2024.1338253. eCollection 2024.
7
Impact of same-admission percutaneous coronary intervention on periprocedural outcomes of transcatheter aortic valve implantation.同期经皮冠状动脉介入治疗对经导管主动脉瓣植入围手术期结局的影响。
Proc (Bayl Univ Med Cent). 2023 Dec 20;37(1):7-13. doi: 10.1080/08998280.2023.2273742. eCollection 2024.
8
Percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis.经导管主动脉瓣植入术患者的经皮冠状动脉介入治疗：一项系统评价和荟萃分析。
Neth Heart J. 2023 Dec;31(12):489-499. doi: 10.1007/s12471-023-01824-w. Epub 2023 Nov 1.
9
A Clinical Audit on the Indications for Intervention With Transcatheter Aortic Valve Implantation Over Surgical Aortic Valve Replacement in Aortic Stenosis Patients in Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre.穆罕默德·本·哈利法·本·萨勒曼·阿勒哈利法心脏专科中心关于主动脉瓣狭窄患者经导管主动脉瓣植入术与外科主动脉瓣置换术干预指征的临床审计
Cureus. 2023 May 19;15(5):e39249. doi: 10.7759/cureus.39249. eCollection 2023 May.
10
Evolving Devices and Material in Transcatheter Aortic Valve Replacement: What to Use and for Whom.经导管主动脉瓣置换术中不断发展的器械和材料：用什么以及适用于谁。
J Clin Med. 2022 Jul 30;11(15):4445. doi: 10.3390/jcm11154445.
本文引用的文献
1
Observations from a real-time, iFR-FFR "hybrid approach" in patients with severe aortic stenosis and coronary artery disease undergoing TAVI.对重度主动脉瓣狭窄和冠状动脉疾病患者在接受经导管主动脉瓣植入术（TAVI）时采用实时瞬时无波形比值（iFR）-血流储备分数（FFR）“混合方法”的观察。
Cardiovasc Revasc Med. 2018 Apr-May;19(3 Pt B):355-359. doi: 10.1016/j.carrev.2017.09.019. Epub 2017 Oct 3.
2
2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS.2017年欧洲心脏病学会（ESC）与欧洲心胸外科学会（EACTS）合作制定的冠状动脉疾病双联抗血小板治疗重点更新内容。
Eur J Cardiothorac Surg. 2018 Jan 1;53(1):34-78. doi: 10.1093/ejcts/ezx334.
3
2017 ESC/EACTS Guidelines for the management of valvular heart disease.2017年欧洲心脏病学会/欧洲心胸外科学会瓣膜性心脏病管理指南。
Eur Heart J. 2017 Sep 21;38(36):2739-2791. doi: 10.1093/eurheartj/ehx391.
4
Impact of coronary artery disease in patients undergoing transfemoral transcatheter aortic valve implantation.经股动脉入路行经导管主动脉瓣置换术患者的冠状动脉疾病影响。
Int J Cardiol. 2017 Oct 15;245:215-221. doi: 10.1016/j.ijcard.2017.07.082. Epub 2017 Jul 25.
5
The Prognostic Effects of Coronary Disease Severity and Completeness of Revascularization on Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement.经导管主动脉瓣置换术患者的冠状动脉疾病严重程度和血运重建完全性对死亡率的预后影响。
JACC Cardiovasc Interv. 2017 Jul 24;10(14):1428-1435. doi: 10.1016/j.jcin.2017.04.035.
6
Transcatheter Aortic Valve Implantation With or Without Percutaneous Coronary Artery Revascularization Strategy: A Systematic Review and Meta-Analysis.经导管主动脉瓣植入术联合或不联合经皮冠状动脉血运重建策略：一项系统评价与荟萃分析
J Am Heart Assoc. 2017 Jun 27;6(6):e005960. doi: 10.1161/JAHA.117.005960.
7
Effects of coronary artery disease in patients undergoing transcatheter aortic valve implantation: A study of age- and gender-matched cohorts.经导管主动脉瓣植入术患者的冠状动脉疾病的影响：一项年龄和性别匹配队列研究。
Int J Cardiol. 2017 Sep 15;243:150-155. doi: 10.1016/j.ijcard.2017.05.071. Epub 2017 May 17.
8
Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients.中危患者的外科手术或经导管主动脉瓣置换术。
N Engl J Med. 2017 Apr 6;376(14):1321-1331. doi: 10.1056/NEJMoa1700456. Epub 2017 Mar 17.
9
Impact of Coronary Artery Disease Severity Assessed With the SYNTAX Score on Outcomes Following Transcatheter Aortic Valve Replacement.用SYNTAX评分评估的冠状动脉疾病严重程度对经导管主动脉瓣置换术后结局的影响。
J Am Heart Assoc. 2017 Feb 20;6(2):e005070. doi: 10.1161/JAHA.116.005070.
10
SOURCE 3 Registry: Design and 30-Day Results of the European Postapproval Registry of the Latest Generation of the SAPIEN 3 Transcatheter Heart Valve.SOURCE 3 注册研究：新一代 SAPIEN 3 经导管主动脉瓣的欧洲上市后注册研究的设计和 30 天结果。
Circulation. 2017 Mar 21;135(12):1123-1132. doi: 10.1161/CIRCULATIONAHA.116.025103. Epub 2017 Jan 19.
Zotero 插件