Acute Coronary Syndrome in Transcatheter Aortic Valve Replacement: Defend the Coronary Circulation

Abstract:

aortic valve replacement (TAVR) has become an important, and often preferred, therapeutic option for patients with severe symptomatic aortic stenosis (AS), especially in the intermediate-risk and the high-risk patient populations (1–7). Many of the initial challenges of TAVR, especially paravalvular leak and acute coronary occlusion, have been significantly improved with advanced pre-procedural planning with gated computed tomographic imaging allowing more precise valve sizing, improved valve designs, and post-balloon dilation when needed. Other challenges, such as reduction in pacemaker rates, have also improved with newer-generation valve designs, greater operator experience, and more conservative electrophysiology algorithms. As TAVR moves into the lower-risk population, long-term management of coronary artery disease assumes greater importance. In this issue of JACC: Cardiovascular …

Año de publicación:

2018

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