GLOBAL SUMMIT ON CARDIOLOGY AND CARDIO CARE
NOVEMBER 30- DECEMBER 01, 2023 | DUBAI, UAE
Theme: Research Trends and Advances in Cardiology
David Iosseliani
Sechenov First Moscow State Medical University, Russian FederationTitle: Simultaneous transfemoral endovascular procedures for aortic valve replacement (TAVI) and percutaneous coronary intervention (PCI) in old patients with concomitant aortic valve atherosclerotic stenosis (AVAS) and coronary artery disease (CAD)
Abstract
Aim. To evaluate the effectiveness, the safety and
the feasibility of simultaneous combined procedure of TAVI and coronary
arteries stenting in elderly and old patients with AVAS and CAD at high
surgical risk.
Methods and results: 173 patients were
assigned to two groups: I – patients with AVAS and CAD who underwent TAVI with
simultaneous stenting of the coronary arteries (n=35); II – patients with AVAS
without severe stenotic changes in the coronary arteries (n=138). The patients
from Group I underwent coronary arterial stenting (1,8 ± 0,8 stented vessels per
patient), and then – aortic valve implantation in conformity with the standard
technique. The patients from Group II underwent only TAVI. The success of
procedures in both groups was 100%, there were no intra- or perioperative
deaths, acute myocardial infarction, acute brain stroke, acute renal failure
requiring dialysis. The groups differed in procedure duration (139,5 ± 19,4 vs.
117± 15,3 min); x-ray exposure duration (39,4 ±10,1 vs.22+7.3 min); the volume
of contrast agent used (371,4 ± 89,4 vs. 316,8+ 43,4 ml). Maximal transvalvular
systolic pressure gradient after the procedure, paraprosthetic regurgitation,
as well as the rate of such complications as complete AV block (3,2% vs 3,9%)
and left bundle branch block (25% vs. 21%) were not statistically different
between the groups.
Conclusions: Combined simultaneous management
of elderly and old patients with severe aortic stenosis and CAD is effective,
feasible and safe. Within the first 30 days after the procedure there were no
significant differences in mortality and severe complications rate between
those who underwent simultaneous coronary arteries stenting and TAVI and those,
in whom were performed TAVI only.
Biography
Prof. David Iosseliani, Academician of Russian Academy
of Sciences FACC, FESC, is one of the
most renowned Russian interventional cardiologists and of the pioneers of this
discipline in Russia. He is Head of the
Chair of Interventional Cardioangiology at Sechenov Medical University and
President of the Center of Interventional Cardioangiology in Moscow, Russia. He
is the author of over 450 publications, several monographs and book chapters,
several Patents. He attended numerous International Conferences and Congresses
as moderator, lecturer and member of the organizing committees. He is the
founder and (at present) first Vice-President of Russian Society of
Interventional Cardioangiology, Editor-in-Chief of “International Journal of
interventional Cardioangiology” and member of the Editorial Boards of several
medical journals.
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