Patel, KP;
Michail, M;
Treibel, TA;
Rathod, K;
Jones, DA;
Ozkor, M;
Kennon, S;
... Baumbach, A; + view all
(2021)
Coronary Revascularization in Patients Undergoing Aortic Valve Replacement for Severe Aortic Stenosis.
JACC: Cardiovascular Interventions
, 14
(19)
pp. 2083-2096.
10.1016/j.jcin.2021.07.058.
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Abstract
Aortic stenosis (AS) and coronary artery disease (CAD) frequently coexist, with up to two thirds of patients with AS having significant CAD. Given the challenges when both disease states are present, these patients require a tailored approach diagnostically and therapeutically. In this review the authors address the impact of AS and aortic valve replacement (AVR) on coronary hemodynamic status and discuss the assessment of CAD and the role of revascularization in patients with concomitant AS and CAD. Remodeling in AS increases the susceptibility of myocardial ischemia, which can be compounded by concomitant CAD. AVR can improve coronary hemodynamic status and reduce ischemia. Assessment of the significance of coexisting CAD can be done using noninvasive and invasive metrics. Revascularization in patients undergoing AVR can benefit certain patients in whom CAD is either prognostically or symptomatically important. Identifying this cohort of patients is challenging and as yet incomplete. Patients with dual pathology present a diagnostic and therapeutic challenge; both AS and CAD affect coronary hemodynamic status, they provoke similar symptoms, and their respective treatments can have an impact on both diseases. Decisions regarding coronary revascularization should be based on understanding this complex relationship, using appropriate coronary assessment and consensus within a multidisciplinary team.
| Type: | Article |
|---|---|
| Title: | Coronary Revascularization in Patients Undergoing Aortic Valve Replacement for Severe Aortic Stenosis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jcin.2021.07.058 |
| Publisher version: | https://doi.org/10.1016/j.jcin.2021.07.058 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Aortic stenosis, coronary artery disease, chronic coronary syndromes, revascularization, coronary hemodynamics |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10136488 |
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