Assessing the Significance of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic-Valve Replacement

Quantitative coronary flow reserve was superior to angiography for the prognostic impact of CAD in this retrospective analysis.

The identification and management of coronary artery disease (CAD) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) are controversial and the subjects of ongoing trials. In a retrospective Italian multicenter study, investigators examined mortality predictions from two methods of assessing CAD stenosis severity — visual angiographic estimates versus quantitative coronary flow reserve (QFR) assessed angiographically without a wire — in 318 patients undergoing TAVR (median age, 84; 55% women).

Patients' CAD risk factors included hypertension (87%), diabetes (26%), and previous myocardial infarction (14%). During 3 years of follow-up, 22% of patients died. Rates of death did not differ betwee…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)