PMID- 24532332
OWN - NLM
STAT- MEDLINE
DCOM- 20160509
LR  - 20201216
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 83
IP  - 4
DP  - 2014 Mar 1
TI  - Comparison of early and late outcomes of TAVI alone compared to TAVI plus PCI in 
      aortic stenosis patients with and without coronary artery disease.
PG  - 649-54
LID - 10.1002/ccd.25233 [doi]
AB  - OBJECTIVES: To assess the safety and effectiveness of performing percutaneous 
      coronary intervention (PCI) before transcatheter aortic valve implantation 
      (TAVI). BACKGROUND: The presence of coronary artery disease (CAD) negatively 
      impact procedural outcomes and long-term survival after (TAVI). The management of 
      obstructive CAD before TAVI is not yet well established. METHODS: Patients with 
      severe symptomatic aortic stenosis (AS) (n = 249) that underwent TAVI were 
      divided into two groups: patients with CAD (subdivided to patients treated with 
      TAVI alone and to patients that underwent PCI before TAVI) and patients with 
      isolated AS. Procedural endpoints, device success and adverse events were 
      considered according to the Valve Academic Research Consortium (VARC) 
      definitions. RESULTS: Of a cohort of 249 consecutive patients with mean age of 
      83.2 +/- 5.5 years, 83 patients with AS + CAD were treated with TAVI alone, 61 
      patients with AS + CAD underwent PCI before TAVI and 105 patients underwent TAVI 
      for isolated AS. The mean duration of follow-up was 17 months (range: 6-36 
      months). Despite a significantly higher logistic EuroScore of the AS+CAD group 
      compared to the AS alone group (30.1 vs. 21.1 P < 0. 001), the overall 
      VARC-adjudicated endpoints did not differ between the groups. All-cause mortality 
      at 30-days was 1.6% for patients with AS+CAD treated with PCI compared to 2.9% 
      for patients with AS alone (P = 1). CONCLUSIONS: Performing PCI before TAVI in 
      high-risk elderly patients with significant CAD and severe AS is feasible and 
      safe. This combined treatment approach did not increase the periprocedural risk 
      for complications or the all-cause mortality.
CI  - Copyright (c) 2013 Wiley Periodicals, Inc.
FAU - Abramowitz, Yigal
AU  - Abramowitz Y
AD  - Department of Cardiology, The Tel-Aviv Medical Center, Tel-Aviv, Israel; Sackler 
      Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
FAU - Banai, Shmuel
AU  - Banai S
FAU - Katz, Guy
AU  - Katz G
FAU - Steinvil, Arie
AU  - Steinvil A
FAU - Arbel, Yaron
AU  - Arbel Y
FAU - Havakuk, Ofer
AU  - Havakuk O
FAU - Halkin, Amir
AU  - Halkin A
FAU - Ben-Gal, Yanai
AU  - Ben-Gal Y
FAU - Keren, Gad
AU  - Keren G
FAU - Finkelstein, Ariel
AU  - Finkelstein A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20131031
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/complications/diagnosis/mortality/*therapy
MH  - *Cardiac Catheterization/adverse effects/mortality
MH  - Coronary Artery Disease/complications/diagnosis/mortality/*therapy
MH  - Feasibility Studies
MH  - Female
MH  - Heart Valve Prosthesis Implantation/adverse effects/*methods/mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - *Percutaneous Coronary Intervention/adverse effects/mortality
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - aortic stenosis
OT  - percutaneous coronary intervention
OT  - transcatheter aortic valve implantation
EDAT- 2014/02/18 06:00
MHDA- 2016/05/10 06:00
CRDT- 2014/02/18 06:00
PHST- 2013/06/09 00:00 [received]
PHST- 2013/09/03 00:00 [revised]
PHST- 2013/09/29 00:00 [accepted]
PHST- 2014/02/18 06:00 [entrez]
PHST- 2014/02/18 06:00 [pubmed]
PHST- 2016/05/10 06:00 [medline]
AID - 10.1002/ccd.25233 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2014 Mar 1;83(4):649-54. doi: 10.1002/ccd.25233. Epub 
      2013 Oct 31.