Functional Assessment of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Implantation

Pesarini, Gabriele; Scarsini, Roberto; Zivelonghi, Carlo; Piccoli, Anna; Gambaro, Alessia; Gottin, Leonardo; Rossi, Andrea; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio

doi:10.1161/circinterventions.116.004088

Cited by 112 publications

(80 citation statements)

References 37 publications

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“…Some intermediate stenoses with normal or borderline FFR values pre‐TAVR may be underestimated. The incidence of misclassification is 6%–8% . The correlation between iFR and FFR is reasonable but the diagnostic accuracy of iFR was significantly lower in AS with CAD (76.3% vs. 86.1%, P = 0.009).…”

Section: Clinical Utility Of Translesional Measurementsmentioning

confidence: 84%

“…The accuracy of FFR and iFR is uncertain when assessing coronary stenosis severity in AS prior to TAVR. In severe AS, the conventional iFR cut-off has lower diagnostic agreement with FFR compared to stable CAD patients [36,37]. These techniques have been evaluated in small series and the data are weak and inconsistent (Table 4).…”

Section: Aortic Stenosis (As) and Tavrmentioning

confidence: 99%

“…Some intermediate stenoses with normal or borderline FFR values pre-TAVR may be underestimated. The incidence of misclassification is 6%-8% [36]. The Abbreviations: FFR, fractional flow reserve; Revas, revascularization; non-STEMI, non-ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction; Angio, angiographically.…”

Section: Aortic Stenosis (As) and Tavrmentioning

confidence: 99%

See 2 more Smart Citations

Focused update of expert consensus statement: Use of invasive assessments of coronary physiology and structure: A position statement of the society of cardiac angiography and interventions

Lotfi

Davies

Fearon

et al. 2018

Cathet Cardio Intervent

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Section: Clinical Utility Of Translesional Measurementsmentioning

confidence: 84%

Section: Aortic Stenosis (As) and Tavrmentioning

confidence: 99%

Section: Aortic Stenosis (As) and Tavrmentioning

confidence: 99%

See 1 more Smart Citation

Focused update of expert consensus statement: Use of invasive assessments of coronary physiology and structure: A position statement of the society of cardiac angiography and interventions

Lotfi

Davies

Fearon

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

“…Previous work has demonstrated the effect of afterload on whole-cycle indices 25 but not those from the wave-free window. Previous work has demonstrated the effect of afterload on whole-cycle indices 25 but not those from the wave-free window.…”

Section: Applications and Future Directionsmentioning

confidence: 92%

“…The invasive assessment of coronary stenoses in aortic stenosis is a debated subject. Previous work has demonstrated the effect of afterload on whole-cycle indices 25 but not those from the wave-free window. 26 Our work fits with these findings as we have demonstrated changes in the wave intensity profile but not wave-free window.…”

Section: Applications and Future Directionsmentioning

confidence: 92%

Regression of left ventricular hypertrophy provides an additive physiological benefit following treatment of aortic stenosis: Insights from serial coronary wave intensity analysis

et al. 2018

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In aortic stenosis, both the outflow tract gradient and the presence of LVH impact significantly on coronary haemodynamics that cannot be appreciated by examining resting coronary flow rates alone. An immediate change in coronary wave intensity occurs following intervention with further effects appreciable with hypertrophy regression. The improvement in prognosis with treatment is likely to be attributable to both features.

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Adverse clinical outcomes in patients undergoing both PCI and TAVR: Analysis from a pooled multi‐center registry

Kumar

Sammour

Reginauld

et al. 2020

Cathet Cardio Intervent

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Background There is a paucity of data regarding the optimum timing of PCI in relation to TAVR. Objective We compared the major adverse cardiovascular and cerebrovascular events (MACCE) rates among patients who underwent percutaneous coronary intervention (PCI) before transcatheter aortic valve replacement (TAVR) with those who received PCI with/after TAVR. Methods In this multicenter study, we pooled all consecutive patients who underwent TAVR at three high volume centers. Results Among 3,982 patients who underwent TAVR, 327 (8%) patients underwent PCI within 1 year before TAVR, 38 (1%) had PCI the same day as TAVR and 15 (0.5%) had PCI within 2 months after TAVR. Overall, among patients who received both PCI and TAVR (n = 380), history of previous CABG (HR:0.501; p = .001), higher BMI at TAVR (HR:0.970; p = .038), and statin therapy after TAVR (HR:0.660, p = .037) were independently associated with lower MACCE while warfarin therapy after TAVR was associated with a higher risk of MACCE (HR:1.779, p = .017). Patients who received PCI within 1 year before TAVR had similar baseline demographics, STS scores, clinical risk factors when compared to patients receiving PCI with/after TAVR. Both groups were similar in PCI (Syntax Score, ACC/AHA lesion class) and TAVR (valve types, access) related variables. There were no significant differences in terms of MACCE (log rank p = .550), all‐cause mortality (log rank p = .433), strokes (log rank p = .153), and repeat PCI (log rank p = .054) in patients who underwent PCI with/after TAVR when compared to patients who received PCI before TAVR. Conclusion Among patients who underwent both PCI and TAVR, history of CABG, higher BMI, and statin therapy had lower, while those discharged on warfarin, had higher adverse event rates. Adverse events rates were similar regardless of timing of PCI.

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Functional Assessment of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Implantation

Abstract: Background-Aortic

Cited by 112 publications

References 37 publications

Focused update of expert consensus statement: Use of invasive assessments of coronary physiology and structure: A position statement of the society of cardiac angiography and interventions

Focused update of expert consensus statement: Use of invasive assessments of coronary physiology and structure: A position statement of the society of cardiac angiography and interventions

Regression of left ventricular hypertrophy provides an additive physiological benefit following treatment of aortic stenosis: Insights from serial coronary wave intensity analysis

Adverse clinical outcomes in patients undergoing both PCI and TAVR: Analysis from a pooled multi‐center registry

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