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01.03.2018 | Coronary Artery Disease (D Feldman and V Voudris, Section Editors) | Ausgabe 3/2018

Current Treatment Options in Cardiovascular Medicine 3/2018

Timing and Outcomes of PCI in the TAVR Era

Current Treatment Options in Cardiovascular Medicine > Ausgabe 3/2018
MD, PhD Konstantinos V. Voudris, MD Peter Petropulos, MD Panagiotis Karyofillis, MD Konstantinos Charitakis
Wichtige Hinweise
This article is part of the Topical Collection on Coronary Artery Disease


Purpose of review

Transcatheter aortic valve replacement (TAVR) has become an established therapy for patients with symptomatic severe aortic stenosis (AS). As the number of patients referred for TAVR increases, so does the prevalence of untreated obstructive coronary artery disease (CAD) in the population under evaluation. Despite the high prevalence of CAD in patients treated with TAVR, the management strategy of concomitant CAD in these patients remains an area of considerable uncertainty.

Recent findings

Percutaneous coronary intervention (PCI) in patients with CAD and severe AS has been shown to be feasible and safe. Whether revascularization before, during, or after TAVR is optimal remains a subject of debate. All three approaches represent valid strategies with advantages and disadvantages that need to be carefully weighed on an individual basis.


Current expert opinions recommend that PCI should be performed before or at the time of TAVR as long as the risk of the procedure does not outweigh the potential benefits. The results of large clinical trials evaluating the optimal revascularization time are closely awaited.

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