Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation

Article Article scientifique Article Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation eng 2020-05-21 2022 author Perrin Nils 660226 author Fassa Amir-Ali 794926 author Baroz Antoine 746632 author Frangos Caroline 89489 author Mock Stéphane Daniel 41296 author Frei Angela author Cimci Murat author Degrauwe Sophie 893685 author Roffi Marco 669427 author Iglesias Juan Fernando 897167 author Noble Stéphane Laurent 0000-0002-8018-2857 87673 197-204 10.5603/CJ.a2020.0073 32436588 1898-018X PMC9007485 Background: Performing selective coronary angiogram (CA) and percutaneous coronary intervention (PCI) post transcatheter aortic valve implantation (TAVI) may be challenging with various success rates of coronary ostia engagement. Methods: Among all patients who underwent CA and/or PCI after TAVI from our single center TAVI registry, ostia cannulation success was reported according to the quality of ostia engagement and artery opacification, and was classified as either selective, partially selective or non-selective but sufficient for diagnosis. Results: Among the 424 consecutive TAVI procedures performed at the aforementioned institution, 20 (4.7%) CA were performed in 19 (4.5%) patients at a median time of 464 days post TAVI (25-75% IQ: 213-634 days). CA were performed in 7 CoreValve, 9 Evolut R, 1 Evolut PRO and 2 Edwards Sapien 3 devices. Transradial vascular approach was attempted in 9 procedures (45%, right n = 6 and left n = 3) and was successful in 8 (40%) patients. A total of 20 left main artery ostium cannulation were attempted leading to a diagnostic CA in all of them with selective engagement in 65%. Engagement of the right coronary artery in 2 out of 15 attempted cases failed due to a low ostium in conjunction with a high implantation of a CoreValve prosthesis. 11 PCI (55% of CA) including 2 left main lesions were performed. In 4 patients (36.4% of the PCI), an extension catheter was required to engage the left main. All planned PCI were successful. Conclusions: Post TAVI CA and PCI are challenging but feasible even after supra-annular self-expandable valve implantation. Coronary angiogram Percutaneous coronary intervention Self-expandable transcatheter heart valve Transcatheter aortic valve implantation Aortic Valve / diagnostic imaging Aortic Valve / surgery Aortic Valve Stenosis / diagnostic imaging Aortic Valve Stenosis / surgery Cardiac Catheterization Coronary Angiography Heart Valve Prosthesis Humans Percutaneous Coronary Intervention / adverse effects Prosthesis Design Risk Factors Transcatheter Aortic Valve Replacement / adverse effects Treatment Outcome Dewey 616 56 Département de médecine 221 false Cardiology Journal 29 2 bc6eb1c9-e945-4162-a894-98f9ab885938 Article (Published version) Public Article-scientifique-from-europePmc.pdf 660156 application/pdf CC BY-NC-ND openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Complexity assessment and technical aspect of coronary angiogram and percutaneous coronary intervention following transcatheter aortic valve implantation	Cardiology Journal			2022	192	192

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Fassa, Amir-Ali