The Rationale for Performance of Coronary Angiography and Stenting Before Transcatheter Aortic Valve Replacement: From the Interventional Section Leadership Council of the American College of Cardiology

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• 作者：Stephen Ramee ; MD^a ; Saif Anwaruddin ; MD^b ; Gautam Kumar ; MD^c ; Robert N. Piana ; MD^d ; Vasilis Babaliaros ; MD^e ; Tanveer Rab ; MD^e ; Lloyd W. Klein ; MD^f ; ^{lloydklein@comcast.net} ; for the Aortic Stenosis AUC Writing Group
• 关键词：appropriateness ; coronary stenting ; TAVR
• 刊名：JACC: Cardiovascular Interventions
• 出版年：2016
• 出版时间：12 December 2016
• 年：2016
• 卷：9
• 期：23
• 页码：2371-2375
• 全文大小：403 K
• 卷排序：9

文摘

Transcatheter aortic valve replacement (TAVR) is an effective, nonsurgical treatment option for patients with severe aortic stenosis. The optimal treatment strategy for treating concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. Nevertheless, it is standard practice in the United States to perform coronary angiography and percutaneous coronary intervention for significant CAD at least 1 month before TAVR. All existing clinical trials were designed using this strategy. Therefore, it is wrong to extrapolate current American College of Cardiology/American Heart Association Appropriate Use Criteria against invasive procedures in asymptomatic patients to the TAVR population when evaluating the quality of care by cardiologists or hospitals. In this statement from the Interventional Section Leadership Council of the ACC, it is recommended that percutaneous coronary intervention should be considered in all patients with significant proximal coronary stenosis in major coronary arteries before TAVR, even though the indication is not covered in current guidelines.