Coronary Hemodynamics in Patients With Severe Aortic Stenosis and Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement: Implications for Clinical Indices of Coronary Stenosis Severity.

JACC. Cardiovascular Interventions
Yousif AhmadSayan Sen

Abstract

In this study, a systematic analysis was conducted of phasic intracoronary pressure and flow velocity in patients with severe aortic stenosis (AS) and coronary artery disease, undergoing transcatheter aortic valve replacement (TAVR), to determine how AS affects: 1) phasic coronary flow; 2) hyperemic coronary flow; and 3) the most common clinically used indices of coronary stenosis severity, instantaneous wave-free ratio and fractional flow reserve. A significant proportion of patients with severe aortic stenosis (AS) have concomitant coronary artery disease. The effect of the valve on coronary pressure, flow, and the established invasive clinical indices of stenosis severity have not been studied. Twenty-eight patients (30 lesions, 50.0% men, mean age 82.1 ± 6.5 years) with severe AS and coronary artery disease were included. Intracoronary pressure and flow assessments were performed at rest and during hyperemia immediately before and after TAVR. Flow during the wave-free period of diastole did not change post-TAVR (29.78 ± 14.9 cm/s vs. 30.81 ± 19.6 cm/s; p = 0.64). Whole-cycle hyperemic flow increased significantly post-TAVR (33.44 ± 13.4 cm/s pre-TAVR vs. 40.33 ± 17.4 cm/s post-TAVR; p = 0.006); this was secondary to signifi...Continue Reading

Citations

Aug 17, 2019·Circulation. Cardiovascular Interventions·Hannah Z R McConkeyBernard D Prendergast
May 24, 2019·Journal of Cardiovascular Translational Research·Roberto ScarsiniFlavio Ribichini
Feb 28, 2020·Journal of the American Heart Association·Jo M ZelisNils P Johnson
Jul 23, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Murat CimciJuan F Iglesias
Aug 28, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Arnav KumarHabib Samady
Dec 14, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Tiffany PattersonSimon Redwood
Aug 11, 2020·Journal of Interventional Cardiology·Jo M ZelisNils P Johnson
Oct 3, 2020·Open Heart·Michael MichailAdam J Brown
Feb 4, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Martin Sejr-HansenAshkan Eftekhari
Feb 6, 2021·JACC. Cardiovascular Interventions·Andrea ComellaAdam J Brown
Apr 4, 2021·Journal of Clinical Medicine·Federico MarinAdrian P Banning
Nov 29, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Brian C CaseToby Rogers
May 25, 2021·Revista Española De Cardiología·Pawel KleczynskiJacek Legutko

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

LabVIEW
MATLAB
Volcano
ComboMap

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