Page 45 - Read Online

Page 8 of 13 Cangemi et al. Mini-invasive Surg 2022;6:3 https://dx.doi.org/10.20517/2574-1225.2021.99

Table 2. Features of the main study on the hybrid approach off-pump coronary artery bypass and TAVI

Number of TAVI In-hospital 30 days Long term
patients Surgical rik score approaches Revescularization characteristics Complications mortality mortality survival rate

Baumbach et al. [69] 50 36.4 ± 22.4 (Euroscore I) Tao (21) MIDCAB via left antero-lateral AKI stage II/III (5) 9 (18%) 8 (16%) 65.5% at 12
TA (29) minithoracotomy in the case of single-vessel Re-thoracotomy (5) months
LAD or LCX artery disease; Pericardial tamponade (1)
OPCAB via median sternotomy in the case of Stroke (1)
multi-vessel complex disease Periprocedural myocardial
infarction (1)
Ahad et al. [70] 70 35.9 ± 21.9 (Logistic Tao (28) MIDCAB (36; 51.4%) AKI stage II/III (6) 14 (20%) 10 (14.3%) 74.4% at 12
Euroscore) TA (42) OPCAB (32; 45.7%) Re-thoracotomy (6) months
LIMA (66) Pericardial tamponade (1) 68.4% at 24
RIMA (21) Stroke (1) months
Vein (7) Periprocedural myocardial
Radial artery (2) infarction (1)

Mayr et al. [71] 20 16.1 (9.3-28.1) (Logistic Tao (9) OPCAB (6) AKI stage II/III (2) 0 0 75% at 42
Euroscore TA (5) MIDCAB (14) Re-thoracotomy (1) months
TF (5) LIMA (17) Pericardial tamponade (1)
TSC (1) RIMA (6) Stroke (0)
Complete revascularization (75) Periprocedural myocardial
infarction (0)
Pirelli et al. [72] 6 8 ± 3.3 (STS-score) TF (4) MIDCAB (6) Complete heart block (1) 0 0 100% at 12
TA (1) Preceded by PCI and BAV in 3 cases No neurological events or months
Transinnominate major vascular
(1) complications
Zubarevich et al. [77] 10 Mean logistic Euroscore Tao (10) OPCAB (10) Acute kidney injury (2) 1 (10%) 1 (10%) Missing data
(26.5% ± 12.3%), mean STS Complete revascularisation (7) Rethoracotomy (1)
score (6.04% ± 1.6%) LIMA LAD (9) LIMA D1 (1) Pericardial effusion requiring
Planned PCI (3) thoracotomy (1)
Reintubation 1 (10%)
Septic shock 1 (10%)

AKI: Acute kidney injury; BAV: balloon aortic valvuloplasty; D1: first diagonal; LAD: left anterior descending artery; LCX: left circumflex artery; LIMA: left internal mammary artery; MICS-OPCAB: minimally invasive
cardiac surgery coronary artery bypass; MIDCAB: minimally invasive direct CABG; OPCAB: off-pump coronary artery bypass; PCI: percutaneous coronary interventions; RIMA: right internal mammary artery; STS:
Society of Thoracic Surgeons; TA: trans-apical; TAO: trans-aortic; TAVI: transcatheter aortic valve implantation; TCr: transcarotid; TF: trans-femoral; TSC: trans-subclavian.

CONCLUSION

Coronary artery disease is a common finding in patients with degenerative aortic valve stenosis with a prevalence estimated around 40%-75%. The presence of
CAD alone did not affect short-term mortality, while severe CAD was conversely associated with higher one-year mortality. Therefore, important unresolved

questions are if, how, and when to treat coexisting CAD. According to current evidence, complete myocardial revascularization should no longer be
considered an essential requirement for TAVI. The safety and efficacy of functional guided revascularization with FFR or iFR is under evaluation in on-going