Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia, Brescia, Italy.
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Catheter Cardiovasc Interv. 2023 May;101(6):1154-1160. doi: 10.1002/ccd.30653. Epub 2023 Mar 30.
Coronary artery disease (CAD) is a frequent finding in patients with aortic stenosis (AS). Concomitant coronary artery bypass and aortic valve replacement is considered the gold standard treatment in surgical candidates. However, limited evidence is available regarding the role of coronary revascularization in patients undergoing transcatheter aortic valve implantation (TAVI). How to evaluate CAD severity in patients with AS, whether percutaneous coronary intervention (PCI) needs to be performed and what is the timing for revascularization to minimize procedural risks, remains matters of debate. The aim of this review is to summarize epidemiology, diagnostic tools and possible options for CAD management in patients undergoing TAVI with specific focus on the pros and the cons of the different timing of PCI.
冠状动脉疾病（CAD）是主动脉瓣狭窄（AS）患者的常见发现。对于手术候选者，同时进行冠状动脉旁路和主动脉瓣置换被认为是金标准治疗。然而，关于经导管主动脉瓣植入术（TAVI）患者中冠状动脉血运重建的作用，有限的证据可用。如何评估 AS 患者的 CAD 严重程度，是否需要进行经皮冠状动脉介入治疗（PCI）以及何时进行血运重建以最大程度地降低程序风险，仍存在争议。本综述的目的是总结 TAVI 患者 CAD 管理的流行病学、诊断工具和可能的选择，特别关注 PCI 不同时机的优缺点。
