Coronary artery disease and transcatheter aortic valve implantation: diagnostic evaluation, management and indication for percutaneous revascularization

Aortic stenosis (AS) is the most frequent form of valvular heart disease in developed countries, and severe AS is a major cause of morbidity and mortality in the elderly. Since many of these patients often have a high or prohibitive risk for surgical aortic valve replacement (SAVR), transcatheter aortic valve implantation (TAVI) has emerged as an established therapy and is now becoming a common practice, even in low-risk patients. As severe AS and coronary artery disease (CAD) are often concomitant, a matter of debate is whether, how, and when to treat coexisting CAD. The aim of this commentary is to analyze the rationale for the diagnostic evaluation and management of CAD in TAVI candidates, as proposed by the recent EAPCI/ESC consensus statement.