Aortic valve stenosis after previous coronary bypass: transcatheter valve implantation or aortic valve replacement?
We report a prospective comparison between transcatheter valve implantation (TAVI, n = 13) and surgical aortic valve replacement (AVR, n = 10) in patients with severe aortic valve stenosis and previous coronary bypass surgery (CABG). All patients had at least bilateral patent internal thoracic arteries bypass without indication of repeat revascularization. After a similar post-procedure outcome, despite one early death in TAVI group, the 1-year survival was 100% in surgical group and in transfemoral TAVI group, and 73% in transapical TAVI group. When previous CABG is the lone surgical risk factor, indications for a TAVI procedure have to be cautious, specially if transfemoral approach is not possible.
Department of Cardiac Surgery and Transplantation, Hospital Louis Pradel, University Claude Bernard Lyon 1, INSERM Carmen, 28 Avenue du doyen LEPINE, Bron 69677, France. olivier.jegaden@chu-lyon.fr
Olivier
O
Jegaden
Joel
J
Lapeze
Fadi
F
Farhart
Guy
G
de Gevigney
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome