ArticleJACC. Cardiovascular interventions2018
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.
Article in JACC. Cardiovascular interventions, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers.
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59 citing papers in PubMed, 126 citations in OpenAlex.
- Progression of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Replacement: A Quantitative Coronary Angiography and Quantitative Flow Ratio Analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Invasive Evaluation of Coronary Artery Disease in Severe Aortic Stenosis-A Narrative Review.Journal of clinical medicine · 2026Review
- The Contemporary Role of Intracoronary Physiological Assessment: Fractional Flow Reserve, Non-Hyperemic Pressure Ratios, Wireless Technologies, and Microcirculation.Journal of cardiovascular development and disease · 2026Review
- Peak aortic jet velocity as a predictor of short- and long-term outcomes following percutaneous coronary intervention.International journal of cardiology. Heart & vasculature · 2026Article
- How to Individualize Coronary Assessment and Revascularization in Severe AS Patients Undergoing TAVI in the Era of Lifetime Management?Journal of clinical medicine · 2026Review
- Fractional Flow Reserve Derived from a Single Angiographic View: Fact or Fiction?Medicina (Kaunas, Lithuania) · 2026Review
- An Automated Modular Platform for Vascular Graft Assessment via Coronary-like Flow-Induced Stimulation.Bioengineering (Basel, Switzerland) · 2026Article
- Coronary artery disease in patients undergoing transcatheter aortic valve replacement: Current evidence and future directions.American heart journal plus : cardiology research and practice · 2026Review
- Improvement in coronary microvascular dysfunction after transcatheter aortic valve implantation leading to positive fractional flow reserve and percutaneous coronary intervention: a case report.European heart journal. Case reports · 2026Article
- Co-Occurrence of Aortic Stenosis and Coronary Artery Disease: Facing Challenges Before, During, and After Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2025Review
- Coronary Artery Disease and Transcatheter Aortic Valve Replacement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- Hemodynamics of Proximal Coronary Lesions in Patients Undergoing Transcatheter Aortic Valve Implantation: Patient-Specific In Silico Study.Bioengineering (Basel, Switzerland) · 2025Article
- Management of Coronary Artery Disease in the Context of Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-analysis of Percutaneous Coronary Intervention Timing and an Algorithmic Approach to Management.Interventional cardiology (London, England) · 2025Review
- Management of coronary artery disease in patients referred for transcatheter aortic valve replacement.JTCVS structural and endovascular · 2024Article
- Absolute coronary flow and microvascular resistance before and after transcatheter aortic valve implantation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Article
- Prognostic implications of pre-transcatheter aortic valve replacement computed tomography-derived coronary plaque characteristics and stenosis severity.European radiology · 2024Article
- Diagnostic accuracy of Murray law-based quantitative flow ratio in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.Heart and vessels · 2024Article
- How to address the coronaries in TAVI candidates: can the need for revascularization be safely determined by CT angiography only?European heart journal. Imaging methods and practice · 2024Review
- Coronary protection using a pressure wire during transcatheter aortic valve implantation.Journal of cardiology cases · 2024Article
- Contemporary Functional Coronary Angiography: An Update.Future cardiology · 2024Review
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28 authors at 8 institutions in 5 countries.
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Abstract
objectivesIn 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.
backgroundA 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.
methodsTwenty-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.
resultsFlow 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 significant increases in systolic hyperemic flow post-TAVR (27.67 ± 12.1 cm/s pre-TAVR vs. 34.15 ± 17.5 cm/s post-TAVR; p = 0.02). Instantaneous wave-free ratio values did not change post-TAVR (0.88 ± 0.09 pre-TAVR vs. 0.88 ± 0.09 post-TAVR; p = 0.73), whereas fractional flow reserve decreased significantly post-TAVR (0.87 ± 0.08 pre-TAVR vs. 0.85 ± 0.09 post-TAVR; p = 0.001).
conclusionsSystolic and hyperemic coronary flow increased significantly post-TAVR; consequently, hyperemic indices that include systole underestimated coronary stenosis severity in patients with severe AS. Flow during the wave-free period of diastole did not change post-TAVR, suggesting that indices calculated during this period are not vulnerable to the confounding effect of the stenotic aortic valve.
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