Display options
Cite
Chavarria J, Sibbald M, Velianou J, et al. A Computed Tomography Protocol to Evaluate Coronary Artery Disease Before Transcatheter Aortic Valve Replacement. Can J Cardiol. 2021;doi: 10.1016/j.cjca.2021.10.002.
Chavarria, J., Sibbald, M., Velianou, J., Natarajan, M., Jaffer, I., Smith, A., & Sheth, T. (2021). A Computed Tomography Protocol to Evaluate Coronary Artery Disease Before Transcatheter Aortic Valve Replacement. The Canadian journal of cardiology, . https://doi.org/10.1016/j.cjca.2021.10.002
Chavarria, Jorge, et al. "A Computed Tomography Protocol to Evaluate Coronary Artery Disease Before Transcatheter Aortic Valve Replacement." The Canadian journal of cardiology vol. (2021). doi: https://doi.org/10.1016/j.cjca.2021.10.002
Chavarria J, Sibbald M, Velianou J, Natarajan M, Jaffer I, Smith A, Sheth T. A Computed Tomography Protocol to Evaluate Coronary Artery Disease Before Transcatheter Aortic Valve Replacement. Can J Cardiol. 2021 Oct 22; doi: 10.1016/j.cjca.2021.10.002. Epub 2021 Oct 22. PMID: 34688851.
Copy Download .nbib Format: NLM
Share it on

Can J Cardiol. 2021 Oct 22; doi: 10.1016/j.cjca.2021.10.002. Epub 2021 Oct 22.

A Computed Tomography Protocol to Evaluate Coronary Artery Disease Before Transcatheter Aortic Valve Replacement.

The Canadian journal of cardiology

Jorge Chavarria, Matt Sibbald, James Velianou, Madhu Natarajan, Iqbal Jaffer, Amanda Smith, Tej Sheth

Affiliations

  1. McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada.
  2. McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada.

PMID: 34688851 DOI: 10.1016/j.cjca.2021.10.002

Abstract

BACKGROUND: Transcatheter aortic valve replacement (TAVR) computed tomographic angiography (CTA) images can be used to evaluate coronary artery disease (CAD).

METHODS: We conducted a prospective cohort study of consecutive TAVR patients from November 2019 to February 2021 to evaluate TAVR CTA assessment of CAD on the rate of pre-TAVR invasive angiography. Patients had CTA first or invasive angiography first at the discretion of their treating physicians. TAVR CTA scans were categorised as normal/mild CAD, single-vessel disease, high risk (multivessel or left main disease), or nondiagnostic in patients without previous coronary artery bypass grafting (CABG) and as low risk or high risk in patients with previous CABG. Invasive angiography was recommended before TAVR for high-risk or nondiagnostic CTA findings.

RESULTS: TAVR was performed on 354 patients; CTA first was performed in 273 and invasive angiography first in 81. Among 231 patients without previous CABG who had CTA first, 22.1% (51/231) had pre-TAVR invasive angiography and 1.3% (3/231) had pre-TAVR revascularisation. Normal/mild CAD or single-vessel disease was found on CTA in 174 patients, of whom 0.5% (1/174) had high-risk disease on invasive angiography. Among 42 patients with previous CABG who had CTA first, 14.3% (6/42) had pre-TAVR invasive angiography and 2.4% (1/42) had pre-TAVR revascularisation.

CONCLUSION: TAVR CTA CAD evaluation can avoid pre-TAVR invasive angiography in more than 70% of patients while rarely missing high risk findings. A CTA-first strategy to assess CAD should be considered, especially among patients where conservative management of CAD is preferred.

Copyright © 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Publication Types