Transcatheter Aortic Valve Replacement in Patients with Coronary Chronic Total Occlusion

Gifft, Kristina; Brilakis, Emmanouil S.; Kumar, Arun; Omran, Jad; Enezate, Tariq

doi:10.1016/j.carrev.2019.10.025

Cited by 3 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four studies were included in the review. [24][25][26]29 The study design, patient demographics and patient selection criteria for the included studies is shown in Table 1. All four studies were retrospective cohort studies that took place in the United States, Poland and Denmark.…”

Section: Resultsmentioning

confidence: 99%

“…In general, all four studies had seven or more stars according to the Ottawa-Newcastle scale. Two studies either adjusted or used propensity score matching for their survival analysis 25,26 and one study only included in-hospital outcomes. 25 The results and follow up of the studies are shown in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies either adjusted or used propensity score matching for their survival analysis 25,26 and one study only included in-hospital outcomes. 25 The results and follow up of the studies are shown in Table 2. In three studies which reported the overall proportion of patients with 25 The study by Howard et al 26 found that there were no differences in 1-year outcomes for death, myocardial infarction, stroke, Canadian Cardiology Society angina score and New York Heart Association score.…”

Section: Resultsmentioning

confidence: 99%

“…25 The results and follow up of the studies are shown in Table 2. In three studies which reported the overall proportion of patients with 25 The study by Howard et al 26 found that there were no differences in 1-year outcomes for death, myocardial infarction, stroke, Canadian Cardiology Society angina score and New York Heart Association score. The small study of 101 patients by Kleczynski et al 24 reported a significant increase in 1-year-mortality in presence of CTO (55.6% vs. 14.1%, p = 0.008).…”

Section: Resultsmentioning

confidence: 99%

“…One suggested worse outcomes of patients undergoing TAVI with CTOs 24 while two other studies showed no differences in outcome. 25,26 In view of these uncertainties, we performed the present systematic review to better understand and summarize the current body of evidence regarding the relevance of CTO lesions in patients undergoing TAVR.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The impact of chronic total occlusions in patients undergoing transcatheter aortic valve replacement: A systematic review and meta‐analysis

Will

Schwarz

Weiß

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

Coronary artery disease (CAD) is frequently encountered in patients evaluated for transcatheter aortic valve replacement (TAVR) due to severe aortic stenosis. The prognostic relevance of chronic total occlusions (CTOs) in this setting is poorly understood. We conducted a search of MEDLINE and EMBASE to identify studies evaluating patients who underwent TAVR and evaluated outcomes depending on the presence of coronary CTOs. Pooled analysis was performed to estimate the rate and risk ratio for mortality. Four studies involving 25,432 patients fulfilled the inclusion criteria. The follow up ranged from in‐hospital outcomes to 8‐years follow‐up. Coronary artery disease was present in 67.8% to 75.5% of patients in 3 studies which reported this variable. The prevalence of CTOs varied between 2% and 12.6% in this cohort. The presence of CTOs was associated with increase in length of stay (8.1 ± 8.2 vs. 5.9 ± 6.5, p < 0.01), cardiogenic shock (5.1% vs. 1.7%, p < 0.01), acute myocardial infarction (5.8% vs. 2.8%, p = 0.02) and acute kidney injury (18.6% vs. 13.9%, p = 0.048). The pooled 1‐year death rate revealed 41 deaths in 165 patients in the CTO group and 396 deaths in 1663 patients with no CTO ((24.8%) vs. (23.8%)). The meta‐analysis of death with CTO versus no CTO showed a nonsignificant trend toward increased mortality with CTOs (risk ratio 1.11 95% CI 0.90–1.40, I2 = 0%). Our analysis suggests that concomitant CTO lesions in patients undergoing TAVR are common, and its presence was associated with increased in‐hospital complications. However, CTO presence by itself was not associated with increased long‐term mortality, only a nonsignificant trend toward an increased risk of death in patients with CTO was found. Further studies are warranted to assess the prognostic relevance of CTO lesion in TAVR patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The impact of chronic total occlusions in patients undergoing transcatheter aortic valve replacement: A systematic review and meta‐analysis

Will

Schwarz

Weiß

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

The Management of Stable Coronary Artery Disease and Transcatheter Aortic Valve Replacement

2021

View full text Add to dashboard Cite

The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis

Will,

Schwarz,

Weiss

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundCoronary artery disease (CAD) is a common finding in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). However, the impact on prognosis of chronic total occlusions (CTOs), a drastic expression of CAD, remains unclear.Methods and resultsWe retrospectively reviewed 1,487 consecutive TAVR cases performed at a single tertiary care medical center. Pre-TAVR angiograms were analyzed for the presence of a CTO. At the time of TAVR, 11.2% (n = 167) patients had a CTO. There was no significant association between the presence of a CTO and in-hospital or 30-day mortality. There was also no difference in long-term survival. LV ejection fraction and mean aortic gradients were lower in the CTO group.ConclusionsOur analysis suggests that concomitant CTO lesions in patients undergoing TAVR differ in their risk profile and clinical findings to patients without CTO. CTO lesion per se were not associated with increased mortality, nevertheless CTOs which supply non-viable myocardium in TAVR population were associated with increased risk of death. Additional research is needed to evaluate the prognostic significance of CTO lesions in TAVR patients.

show abstract

Transcatheter Aortic Valve Replacement in Patients with Coronary Chronic Total Occlusion

Cited by 3 publications

References 19 publications

The impact of chronic total occlusions in patients undergoing transcatheter aortic valve replacement: A systematic review and meta‐analysis

The impact of chronic total occlusions in patients undergoing transcatheter aortic valve replacement: A systematic review and meta‐analysis

The Management of Stable Coronary Artery Disease and Transcatheter Aortic Valve Replacement

The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis

Contact Info

Product

Resources

About