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Raval et al. Vessel Plus 2024;8:5 Vessel Plus
DOI: 10.20517/2574-1209.2023.99

Review Open Access

Evaluation and management of coronary artery

disease in patients undergoing transcatheter aortic
valve implantation

1
Maharshi Raval , Paul C. Gordon 2
1
Department of Medicine, Landmark Medical Center and New York Medical College, Woonsocket, RI 02895, USA.
2
Lifespan Cardiovascular Institute, Brown University, Providence, RI 02904, USA.
Correspondence to: Dr. Paul C. Gordon, Lifespan Cardiovascular Institute, Brown University, 208 Collyer Street, Providence, RI
02904, USA. E-mail: paulclarkgordon@gmail.com
How to cite this article: Raval M, Gordon PC. Evaluation and management of coronary artery disease in patients undergoing
transcatheter aortic valve implantation. Vessel Plus 2024;8:5. https://dx.doi.org/10.20517/2574-1209.2023.99

Received: 2 Aug 2023 First Decision: 13 Nov 2023 Revised: 18 Dec 2023 Accepted: 17 Jan 2024 Published: 23 Jan 2024
Academic Editors: Giuseppe Andò, Christopher Lau Copy Editor: Fangling Lan Production Editor: Fangling Lan

Abstract
Significant coronary artery disease (CAD) and severe aortic stenosis (AS) are frequent findings in patients who
undergo transcatheter aortic valve implantation (TAVI). With the extension of TAVI in patients who have
intermediate and even low surgical risk, the optimal evaluation and management of concomitant CAD needs to be
determined. Both pre-TAVI evaluation of CAD and indications for revascularization remain a matter of debate. In
this review, we provide an updated overview of the prevailing landscape of CAD in patients undergoing TAVI with a
focus on its prognostic impact, diagnostic evaluation pre-procedure, indications for revascularization, optimal
timing of revascularization, and future directions.

Keywords: Coronary artery disease, aortic stenosis, transcatheter aortic valve implantation, revascularization,
percutaneous coronary intervention

INTRODUCTION
Aortic stenosis (AS) and obstructive coronary artery disease (CAD), which is defined as at least one
coronary artery with ≥ 50% stenosis, are common conditions frequently seen in the same patient, especially
in Western countries . CAD’s prevalence in patients with AS undergoing transcatheter aortic valve
[1]
implantation (TAVI) has varied widely in different randomized controlled trials. The highest prevalence

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