Debate

DOI: 10.4244/EIJ-E-24-00054

TAVI patients with bystander coronary artery disease should receive PCI: pros and cons

Josep Rodés-Cabau1,2, MD, PhD; Marisa Avvedimento1, MD; Benedict McDonaugh3,4, MSc; Tiffany Patterson3,4, PhD

Introduction

The coexistence of coronary artery disease (CAD) and severe aortic stenosis is a frequent and complex clinical scenario, affecting up to 80% of patients undergoing transcatheter aortic valve implantation (TAVI). As the profile of TAVI candidates evolves − with younger patients and longer life expectancies − the prognostic implications of CAD become increasingly relevant. In addition, while aortic stenosis is a life-threatening condition requiring treatment to reduce overall mortality, the management of concomitant CAD is also crucial to improve symptoms. Treating significant CAD may undermine the benefits of TAVI, leading to persistent angina, adverse cardiac events over time, and reduced quality of life. However, stable CAD rarely necessitates urgent intervention, and percutaneous coronary intervention (PCI) carries potential risks (including bleeding, stroke, and acute kidney injury) without clear benefits in this setting. Although two randomised trials investigated this delicate issue, whether treating bystander CAD in patients undergoing TAVI is associated with favourable prognostic implications or merely adds procedural risks remains a matter of debate.

PROS

Josep Rodés-Cabau, MD, PhD; Marisa Avvedimento, MD

Due to the shared pathophysiology...

Sign in to read
the full article

Forgot your password?
No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Volume 20 Number 22
Nov 18, 2024
Volume 20 Number 22
View full issue


Key metrics

Suggested by Cory

10.4244/EIJV10SUA10 Sep 27, 2014
Coronary artery disease in patients undergoing TAVI: why, what, when and how to treat
Stefanini G et al
free

10.4244/EIJV10SUA11 Sep 27, 2014
Coronary artery disease in patients undergoing TAVI - why not to treat
Khawaja M et al
free

10.4244/EIJV9SSA12 Sep 15, 2013
Severe aortic stenosis and coronary artery disease
Stefanini G et al
free

10.4244/EIJV14I11A209 Dec 7, 2018
PCI in TAVI patients: who, why and when?
Patterson T et al
free

Debate

10.4244/EIJ-E-22-00038 Nov 18, 2022
PCI of bystander coronary artery lesions should be performed before TAVI: pros and cons
Amat-Santos I et al
free
Trending articles
166.7

Expert review

10.4244/EIJ-D-21-00690 May 15, 2022
Crush techniques for percutaneous coronary intervention of bifurcation lesions
Moroni F et al
free
92.45

State-of-the-Art Review

10.4244/EIJ-D-20-01296 Aug 27, 2021
Management of cardiogenic shock
Thiele H et al
free
72.95

State-of-the-Art

10.4244/EIJ-D-24-00386 Feb 3, 2025
Mechanical circulatory support for complex, high-risk percutaneous coronary intervention
Ferro E et al
free
60.55

State-of-the-Art

10.4244/EIJ-D-24-00066 Apr 21, 2025
Management of complications after valvular interventions
Bansal A et al
free
58.3

Clinical research

10.4244/EIJ-D-23-00344 Sep 18, 2023
Clinical outcomes of TAVI with the Myval balloon-expandable valve for non-calcified aortic regurgitation
Sanchez-Luna JP et al
free
33.9

CLINICAL RESEARCH

10.4244/EIJ-D-17-00381 Oct 11, 2017
Stent malapposition and the risk of stent thrombosis: mechanistic insights from an in vitro model
Foin N et al
free
33.65

State-of-the-Art

10.4244/EIJ-D-23-00606 Jan 1, 2024
Targeting inflammation in atherosclerosis: overview, strategy and directions
Waksman R et al
free
26

Expert Review

10.4244/EIJ-D-24-00535 May 5, 2025
Catheter-based techniques for pulmonary embolism treatment
Costa F et al
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 7.6
2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2025 Europa Group - All rights reserved