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General Thoracic and Cardiovascular Surgery

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01-12-2013 | Current Topics Review Article

Changing strategy for aortic stenosis with coronary artery disease by transcatheter aortic valve implantation

Author: Junjiro Kobayashi

Published in: General Thoracic and Cardiovascular Surgery | Issue 12/2013

Abstract

Coronary artery disease (CAD) is combined with aortic stenosis (AS) in 40–50 % of patients with typical angina. Recently, transcatheter aortic valve implantation (TAVI) has changed the guideline for AS in patients with high comorbidity. At the same time more than 60 % of isolated CABG has been performed without cardiopulmonary bypass in Japan. CABG is recommended and should be considered in patients with primary indication for AVR and luminal stenosis >70 % in major coronary arteries and the left internal thoracic artery (LITA) by guidelines. AVR is indicated for severe AS undergoing CABG. It is generally accepted to perform AVR for moderate AS at the time of CABG by valve guidelines. However, prophylactic AVR for moderate AS associated with CABG may increase the early operative risk and expose the patients to postoperative long-term valve related complications. AVR after previous CABG poses potential risk for mortality and morbidity. The presence of patent ITA is a significant risk of its injury and difficulty of myocardial protection during aortic cross-clamping. Therefore, at present, for severe AS previous CABG with patent ITA should be one of the definite indications of TAVI. Rationale of TAVI in patients with severe AS and CAD has not been clearly delineated. The safety of TAVI irrespective of the extent and anatomy of CAD is still controversial. PCI is not appropriate before TAVI in high-risk patients with CAD. In the near future hybrid TAVI will be realistic considering least operative mortality and morbidity in high-risk patients.

Exadactylos N, Sugrue DD, Oakley CM. Prevalence of coronary artery disease in patients with isolated aortic valve stenosis. Br Heart J. 1984;51:121–4.PubMedCrossRef

Green SJ, Pizzarello RA, Padmanabhan VT, Ong LY, Hall MH, Tortolani AJ. Relation of angina pectoris to coronary artery disease in aortic valve stenosis. Am J Cardiol. 1985;55:1063–5.PubMedCrossRef

Chobadi R, Wurzel M, Teplitsky I, Menkes H, Tamari I. Coronary artery disease in patients 35 years of age or older with valvular aortic stenosis. Am J Cardiol. 1989;64:811–2.PubMedCrossRef

2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. J Am Coll Cardiol 2008;52:e1–142.

Guidelines on the management of valvular heart disease (version 2012) Eur Heart J. doi:10.1093/eurheartj/ehs109.

Sakata R, Fujii Y, Kuwano H. Thoracic and cardiovascular surgery in Japan during 2008. Gen Thorac Cardiovasc Surg. 2010;58:356–83.PubMedCrossRef

Mullany CJ, Elveback LR, Frye RL, et al. Coronary artery disease and its management: influence on survival in patients undergoing aortic valve replacement. J Am Coll Cardiol. 1987;10:66–72.PubMedCrossRef

Czer LS, Gray RJ, Stewart ME, De Robertis M, Chaux A, Matloff JM. Reduction in sudden late death by concomitant revascularization with aortic valve replacement. J Thorac Cardiovasc Surg. 1988;95:390–400.PubMed

Lytle BW, Cosgrove DM, Goormastic M, Loop FD. Aortic valve replacement and coronary bypass grafting for patients with aortic stenosis and coronary artery disease: early and late results. Eur Heart J 1988;9(suppl E):143–7.

10.

Lund O, Nielsen TT, Pilegaard HK, Magnussen K, Knudsen MA. The influence of coronary artery disease and bypass grafting on early and late survival after valve replacement for aortic stenosis. J Thorac Cardiovasc Surg. 1990;100:327–37.PubMed

11.

Iung B, Drissi MF, Michael PL, et al. Prognosis of valve replacement for aortic stenosis with or without coexisting coronary heart disease: a comparative study. J Heart Valve Dis. 1993;2:430–9.PubMed

12.

Filsoufi F, Aklog L, Adams DH, Byrne JG. Management of mild to moderate aortic stenosis at the time of coronary artery bypass grafting. J Heart Valve Dis 2002;11(suppl 1):S45–S49.

13.

Pereira JJ, Balaban K, Lauer MS, Lytle B, Thomas JD, Garcia MJ. Aortic valve replacement in patients with mild or moderate aortic stenosis and coronary artery surgery. Am J Med. 2005;118:735–42.PubMedCrossRef

14.

Smith WT IV, Ferguson TB Jr, Ryan T, Landorfo CK, Peterson ED. Should coronary artery bypass graft surgery patients with mild or moderate aortic stenosis undergo concomitant aortic valve replacement? A decision analysis approach to the surgical dilemma. J Am Coll Cardiol. 2004;44:1241–7.PubMedCrossRef

15.

Gillinov AM, Garcia MJ. When is concomitant aortic valve replacement indicated in patients with mild to moderate aortic stenosis undergoing coronary revascularization? Curr Cardiol Rep. 2005;7:101–4.PubMedCrossRef

16.

Rosenheck R, Binder T, Porrenta G, et al. Predictors of outcome in severe, asymptomatic, aortic stenosis. N Engl J Med. 2000;343:611–7.CrossRef

17.

Vaturi M, Porter A, Adler Y, et al. The natural history of aortic valve disease after mitral valve surgery. J Am Coll Cardiol. 1999;33:2003–8.PubMedCrossRef

18.

Rosenhek R, Klaar U, Schemper M, et al. Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J. 2004;25:199–205.PubMedCrossRef

19.

Kobayashi J. Current status of coronary artery bypass grafting. Gen Thorac Cardiovasc Surg. 2008;56:260–7.PubMedCrossRef

20.

Ducrocq G, Al-Attar N, Himbert D, et al. Early and mid-term outcomes in patients undergoing transcatheter aortic valve implantation after previous coronary artery bypass grafting. Eur J Cardiothorac Surg. 2012;41:499–504.PubMedCrossRef

21.

Roger VL, Tajik AJ, Bailey KR, Oh JK, Taylor CL, Seward JB. Progression of aortic stenosis in adults: new appraisal using Doppler echocardiography. Am Heart J. 1990;119:331–8.PubMedCrossRef

22.

Davies SW, Gershlick AH, Balcon R. Progression of valvar aortic stenosis: a long-term retrospective study. Eur Heart J. 1991;12:10–4.PubMed

23.

Faggiano P, Ghizzoni G, Sorgato A, et al. Rate of progression of valvular aortic stenosis in adults. Am J Cardiol. 1992;70:229–33.PubMedCrossRef

24.

Peter M, Hoffmann A, Parker C, Luscher T, Burckhardt D. Progression of aortic stenosis: role of age and concomitant coronary artery disease. Chest. 1993;103:1715–9.PubMedCrossRef

25.

Brener SJ, Duffy CI, Thomas JD, Stewart WJ. Progression of aortic stenosis in 394 patients: relation to changes in myocardial and mitral valve dysfunction. J Am Coll Cardiol. 1995;25:305–10.PubMedCrossRef

26.

Otto CM, Burwash IG, Legget ME, et al. Prospective study of asymptomatic valvular aortic stenosis: clinical, echocardiographic, and exercise predictors of outcome. Circulation. 1997;95:2262–70.PubMedCrossRef

27.

Collins JJ Jr, Aranki SF. Management of mild aortic stenosis during coronary artery bypass graft surgery. J Card Surg. 1994;9:145–7.PubMedCrossRef

28.

Fiore AC, Swartz MT, Naunheim KS, et al. Management of asymptomatic mild aortic stenosis during coronary artery operation. Ann Thorac Surg. 1996;61:1693–7.PubMedCrossRef

29.

Hoff SJ, Merrill WH, Stewart JR, Bender HW Jr. Safety of remote aortic valve replacement after prior coronary artery bypass grafting. Ann Thorac Surg. 1996;61:1689–91.PubMedCrossRef

30.

Odell JA, Mullany CJ, Schaff HV, Orszulak TA, Daly RC, Morris JJ. Aortic valve replacement after previous coronary artery bypass grafting. Ann Thorac Surg. 1996;62:1424–30.PubMedCrossRef

31.

Philips BJ, Karavas AN, Aranki SF, et al. Management of mild aortic stenosis during coronary artery bypass surgery: an update, 1992–2001. J Card Surg. 2003;18:507–11.CrossRef

32.

Byrne JG, Karavas AN, Filsoufi F, et al. Aortic valve surgery after previous coronary artery bypass grafting with functioning internal mammary artery grafts. Ann Thorac Surg. 2002;73:779–84.PubMedCrossRef

33.

Smith RL, Ellman PI, Thompson PW, et al. Do you need to clamp a patent left internal thoracic artery-left anterior descending graft in reoperative cardiac surgery? Ann Thorac Surg. 2009;87:742–7.PubMedCrossRef

34.

Fujita T, Kobayashi J, Nakajima H, Toda K. Systemic hyperkalemia and mild hypothermia for valve surgery in patients with patent internal mammary artery graft. Interact Cardiovasc Thorac Surg. 2010;22:3–5.CrossRef

35.

Redlich K, Khaladj N, Peterss S, et al. Conventional aortic valve replacement in patients with concomitant coronary artery disease and previous coronary artery bypass grafting in the era of interventional approach. Eur J Cardiothorac Surg. 2011;40:455–62.PubMed

36.

Dewey TM, Brown DL, Herbert MA, et al. Effect of concomitant coronary artery disease on procedural and late outcomes of transcatheter aortic valve implantation. Ann Thorac Surg. 2010;89:758–67.PubMedCrossRef

37.

Gautier M, Pepein M, Himbert D, et al. Impact of coronary artery disease on indications for transcatheter aortic valve implantation and on procedural outcomes. EuroIntervention. 2011;7:549–55.PubMedCrossRef

38.

Masson JB, Lee M, Boone RH, et al. Impact of coronary artery disease on outcomes after transcatheter aortic valve implantation. Catheter Cardiovasc Interv. 2010;76:165–73.PubMedCrossRef

39.

Kuchulakanti P, Rha SW, Satler LF, et al. Safety of percutaneous coronary artery intervention alone in symptomatic patients with moderate and severe valvular aortic stenosis and coexisting coronary artery disease: analysis of results in 56 patients. J Invasive Cardiol. 2004;16:688–91.PubMed

40.

Alcalasi R, Viola N, Mosseri M, et al. The value of percutaneous coronary intervention in aortic valve stenosis with coronary artery disease. Am J Med 2007;120:185. e7–13.

41.

Goel SS, Agarwal S, Tuzcu EM, et al. Percutaneous coronary intervention in patients with severe aortic stenosis. Circulation. 2012;125:1005–13.PubMedCrossRef

42.

Geist V, Sherif MA, Khattab AA. Successful percutaneous coronary intervention after implantation of a CoreValve percutaneous aortic valve. Catheter Cardiovasc Interv. 2009;73:61–7.PubMedCrossRef

43.

Zajarias A, Eltchaninoff H, Cribier A. Successful coronary intervention after percutaneous aortic valve replacement. Catheter Cardiovasc Interv. 2007;69:522–4.PubMedCrossRef

44.

Kappetein AP, Feldman TE, Mack MJ, et al. Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three vessel disease: 3-year follow-up of the SYNTAX trial. Eur Heart J. 2011;32:2125–34.PubMedCrossRef

45.

Cleveland JC, Shroyer AL, Chen AY, Peterson E, Grover FL. Off-pump coronary artery bypass grafting decreases risk-adjusted mortality and morbidity. Ann Thorac Surg. 2001;72:1282–8.PubMedCrossRef

46.

Plomondon ME, Cleveland JC Jr, Ludwig ST, Grunwald GK, Kiefe CI, Grover FL, et al. Off-pump coronary artery bypass is associated with improved risk adjusted outcomes. Ann Thorac Surg. 2001;72:114–9.PubMedCrossRef

47.

Sabik JF, Gillinov AM, Blackstone EH, Vacha C, Houghtaling PL, Navia J, et al. Does off-pump coronary surgery reduce morbidity and mortality? J Thorac Cardiovasc Surg. 2002;124:698–707.PubMedCrossRef

48.

Cheng W, Denton TA, Fontana GP, Raissi S, Blanche C, Kass RM, et al. Off-pump coronary surgery: effect on early mortality and stroke. J Thorac Cardiovasc Surg. 2002;124:313–20.PubMedCrossRef

49.

Chen DC, Bainbridge D, Martin JE, Novick RJ, Evidence-Based Perioperative Clinical Outcomes Research Group. Does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials. Anesthesiology. 2005;102:188–203.CrossRef

50.

Puskas J, Cheng D, Knight J, Angelini G, DeCannier D, Diegeler A, et al. Off-pump versus conventional coronary artery bypass grafting: a meta-analysis and consensus statement from the 2004 ISMICS consensus conference. Innovations. 2005;1:3–27.PubMed

51.

Shroyer AL, Grover FL, Hattler B, et al. On-pump versus off-pump coronary-artery bypass surgery. N Engl J Med. 2009;361:1827–37.PubMedCrossRef

52.

Mazzitelli D, Piazza N, Bleiziffer S, Lange R. Transapical transcatheter aortic valve implantation and off-pump left internal thoracic artery-left anterior descending anastomosis: back to the future? J Thorac Cardiovasc Surg. 2011;142:e144–6.PubMedCrossRef

53.

Wiegerinck EM, Cocchieri R, Baan J Jr, de Mol BAJM. Hybrid coronary artery bypass grafting and transaortic transcatheter aortic valve implantation. J Thorac Cardiovasc Surg. 2013;145:600–2.PubMedCrossRef

54.

Miller DC, Blackstone EH, Mack MJ, et al. Transcatheter (TAVR) versus surgical (AVR) aortic valve treatment: occurrence, hazard, risk factors, and consequences of neurologic events in the PARTNER trial. J Thorac Cardiovasc Surg. 2012;143:832–43.PubMedCrossRef

55.

Bruschi G, de Marco F, Botta L, et al. Direct aortic access for transcatheter self-expanding aortic bioprosthetic valves implantation. Ann Thorac Surg. 2012;94:497–503.PubMedCrossRef

56.

Kobayashi J, Sasako Y, Bando K, et al. Multiple off-pump coronary revascularization with “aorta no-touch” technique using composite and sequential methods. Heart Surg Forum. 2002;5:114–8.PubMed

Title: Changing strategy for aortic stenosis with coronary artery disease by transcatheter aortic valve implantation
Author: Junjiro Kobayashi
Publication date: 01-12-2013
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 12/2013
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-013-0242-4

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Changing strategy for aortic stenosis with coronary artery disease by transcatheter aortic valve implantation

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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