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Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR

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Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR. / Kim, Won-Keun; Pellegrini, Costanza; Ludwig, Sebastian; Möllmann, Helge; Leuschner, Florian; Makkar, Raj; Leick, Jürgen; Amat-Santos, Ignacio J; Dörr, Oliver; Breitbart, Philipp; Jimenez Diaz, Victor A; Dabrowski, Maciej; Rudolph, Tanja; Avanzas, Pablo; Kaur, Jatinderjit; Toggweiler, Stefan; Kerber, Sebastian; Ranosch, Patrick; Regazzoli, Damiano; Frank, Derk; Landes, Uri; Webb, John; Barbanti, Marco; Purita, Paola; Pilgrim, Thomas; Liska, Branislav; Tabata, Noriaki; Rheude, Tobias; Seiffert, Moritz; Eckel, Clemens; Allali, Abdelhakim; Valvo, Roberto; Yoon, Sung-Han; Werner, Nikos; Nef, Holger; Choi, Yeong-Hoon; Hamm, Christian W; Sinning, Jan-Malte.

In: JACC-CARDIOVASC INTE, Vol. 14, No. 14, 26.07.2021, p. 1578-1590.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Kim, W-K, Pellegrini, C, Ludwig, S, Möllmann, H, Leuschner, F, Makkar, R, Leick, J, Amat-Santos, IJ, Dörr, O, Breitbart, P, Jimenez Diaz, VA, Dabrowski, M, Rudolph, T, Avanzas, P, Kaur, J, Toggweiler, S, Kerber, S, Ranosch, P, Regazzoli, D, Frank, D, Landes, U, Webb, J, Barbanti, M, Purita, P, Pilgrim, T, Liska, B, Tabata, N, Rheude, T, Seiffert, M, Eckel, C, Allali, A, Valvo, R, Yoon, S-H, Werner, N, Nef, H, Choi, Y-H, Hamm, CW & Sinning, J-M 2021, 'Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR', JACC-CARDIOVASC INTE, vol. 14, no. 14, pp. 1578-1590. https://doi.org/10.1016/j.jcin.2021.05.007

APA

Kim, W-K., Pellegrini, C., Ludwig, S., Möllmann, H., Leuschner, F., Makkar, R., Leick, J., Amat-Santos, I. J., Dörr, O., Breitbart, P., Jimenez Diaz, V. A., Dabrowski, M., Rudolph, T., Avanzas, P., Kaur, J., Toggweiler, S., Kerber, S., Ranosch, P., Regazzoli, D., ... Sinning, J-M. (2021). Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR. JACC-CARDIOVASC INTE, 14(14), 1578-1590. https://doi.org/10.1016/j.jcin.2021.05.007

Vancouver

Kim W-K, Pellegrini C, Ludwig S, Möllmann H, Leuschner F, Makkar R et al. Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR. JACC-CARDIOVASC INTE. 2021 Jul 26;14(14):1578-1590. https://doi.org/10.1016/j.jcin.2021.05.007

Bibtex

@article{40422a5f75cf4b63b502c2138355b667,
title = "Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR",
abstract = "OBJECTIVES: The aim of this study was to characterize the feasibility of coronary angiography (CA) and percutaneous coronary intervention (PCI) in acute settings among patients who have undergone transcatheter aortic valve replacement (TAVR).BACKGROUND: Impaired coronary access after TAVR may be challenging and particularly in acute settings could have deleterious consequences.METHODS: In this international registry, data from patients with prior TAVR requiring urgent or emergent CA were retrospectively collected. A total of 449 patients from 25 sites with acute coronary syndromes (89.1%) and other acute cardiovascular situations (10.9%) were included.RESULTS: Success rates were high for CA of the right coronary artery (98.3%) and left coronary artery (99.3%) and were higher among patients with short stent-frame prostheses (SFPs) than in those with long SFPs for CA of the right coronary artery (99.6% vs 95.9%; P = 0.005) but not for CA of the left coronary artery (99.7% vs 98.7%; P = 0.24). PCI of native coronary arteries was successful in 91.4% of cases and independent of valve type (short SFP 90.4% vs long SFP 93.4%; P = 0.44). Guide engagement failed in 6 patients, of whom 3 underwent emergent coronary artery bypass grafting and another 3 died in the hospital. Among patients requiring revascularization of native vessels, independent predictors of 30-day all-cause mortality were prior diabetes, cardiogenic shock, and failed PCI but not valve type or success of coronary engagement.CONCLUSIONS: CA or PCI after TAVR in acute settings is usually successful, but selective coronary engagement may be more challenging in the presence of long SFPs. Among patients requiring PCI, prior diabetes, cardiogenic shock, and failed PCI were predictors of early mortality.",
author = "Won-Keun Kim and Costanza Pellegrini and Sebastian Ludwig and Helge M{\"o}llmann and Florian Leuschner and Raj Makkar and J{\"u}rgen Leick and Amat-Santos, {Ignacio J} and Oliver D{\"o}rr and Philipp Breitbart and {Jimenez Diaz}, {Victor A} and Maciej Dabrowski and Tanja Rudolph and Pablo Avanzas and Jatinderjit Kaur and Stefan Toggweiler and Sebastian Kerber and Patrick Ranosch and Damiano Regazzoli and Derk Frank and Uri Landes and John Webb and Marco Barbanti and Paola Purita and Thomas Pilgrim and Branislav Liska and Noriaki Tabata and Tobias Rheude and Moritz Seiffert and Clemens Eckel and Abdelhakim Allali and Roberto Valvo and Sung-Han Yoon and Nikos Werner and Holger Nef and Yeong-Hoon Choi and Hamm, {Christian W} and Jan-Malte Sinning",
note = "Copyright {\textcopyright} 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2021",
month = jul,
day = "26",
doi = "10.1016/j.jcin.2021.05.007",
language = "English",
volume = "14",
pages = "1578--1590",
journal = "JACC-CARDIOVASC INTE",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "14",

}

RIS

TY - JOUR

T1 - Feasibility of Coronary Access in Patients With Acute Coronary Syndrome and Previous TAVR

AU - Kim, Won-Keun

AU - Pellegrini, Costanza

AU - Ludwig, Sebastian

AU - Möllmann, Helge

AU - Leuschner, Florian

AU - Makkar, Raj

AU - Leick, Jürgen

AU - Amat-Santos, Ignacio J

AU - Dörr, Oliver

AU - Breitbart, Philipp

AU - Jimenez Diaz, Victor A

AU - Dabrowski, Maciej

AU - Rudolph, Tanja

AU - Avanzas, Pablo

AU - Kaur, Jatinderjit

AU - Toggweiler, Stefan

AU - Kerber, Sebastian

AU - Ranosch, Patrick

AU - Regazzoli, Damiano

AU - Frank, Derk

AU - Landes, Uri

AU - Webb, John

AU - Barbanti, Marco

AU - Purita, Paola

AU - Pilgrim, Thomas

AU - Liska, Branislav

AU - Tabata, Noriaki

AU - Rheude, Tobias

AU - Seiffert, Moritz

AU - Eckel, Clemens

AU - Allali, Abdelhakim

AU - Valvo, Roberto

AU - Yoon, Sung-Han

AU - Werner, Nikos

AU - Nef, Holger

AU - Choi, Yeong-Hoon

AU - Hamm, Christian W

AU - Sinning, Jan-Malte

N1 - Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2021/7/26

Y1 - 2021/7/26

N2 - OBJECTIVES: The aim of this study was to characterize the feasibility of coronary angiography (CA) and percutaneous coronary intervention (PCI) in acute settings among patients who have undergone transcatheter aortic valve replacement (TAVR).BACKGROUND: Impaired coronary access after TAVR may be challenging and particularly in acute settings could have deleterious consequences.METHODS: In this international registry, data from patients with prior TAVR requiring urgent or emergent CA were retrospectively collected. A total of 449 patients from 25 sites with acute coronary syndromes (89.1%) and other acute cardiovascular situations (10.9%) were included.RESULTS: Success rates were high for CA of the right coronary artery (98.3%) and left coronary artery (99.3%) and were higher among patients with short stent-frame prostheses (SFPs) than in those with long SFPs for CA of the right coronary artery (99.6% vs 95.9%; P = 0.005) but not for CA of the left coronary artery (99.7% vs 98.7%; P = 0.24). PCI of native coronary arteries was successful in 91.4% of cases and independent of valve type (short SFP 90.4% vs long SFP 93.4%; P = 0.44). Guide engagement failed in 6 patients, of whom 3 underwent emergent coronary artery bypass grafting and another 3 died in the hospital. Among patients requiring revascularization of native vessels, independent predictors of 30-day all-cause mortality were prior diabetes, cardiogenic shock, and failed PCI but not valve type or success of coronary engagement.CONCLUSIONS: CA or PCI after TAVR in acute settings is usually successful, but selective coronary engagement may be more challenging in the presence of long SFPs. Among patients requiring PCI, prior diabetes, cardiogenic shock, and failed PCI were predictors of early mortality.

AB - OBJECTIVES: The aim of this study was to characterize the feasibility of coronary angiography (CA) and percutaneous coronary intervention (PCI) in acute settings among patients who have undergone transcatheter aortic valve replacement (TAVR).BACKGROUND: Impaired coronary access after TAVR may be challenging and particularly in acute settings could have deleterious consequences.METHODS: In this international registry, data from patients with prior TAVR requiring urgent or emergent CA were retrospectively collected. A total of 449 patients from 25 sites with acute coronary syndromes (89.1%) and other acute cardiovascular situations (10.9%) were included.RESULTS: Success rates were high for CA of the right coronary artery (98.3%) and left coronary artery (99.3%) and were higher among patients with short stent-frame prostheses (SFPs) than in those with long SFPs for CA of the right coronary artery (99.6% vs 95.9%; P = 0.005) but not for CA of the left coronary artery (99.7% vs 98.7%; P = 0.24). PCI of native coronary arteries was successful in 91.4% of cases and independent of valve type (short SFP 90.4% vs long SFP 93.4%; P = 0.44). Guide engagement failed in 6 patients, of whom 3 underwent emergent coronary artery bypass grafting and another 3 died in the hospital. Among patients requiring revascularization of native vessels, independent predictors of 30-day all-cause mortality were prior diabetes, cardiogenic shock, and failed PCI but not valve type or success of coronary engagement.CONCLUSIONS: CA or PCI after TAVR in acute settings is usually successful, but selective coronary engagement may be more challenging in the presence of long SFPs. Among patients requiring PCI, prior diabetes, cardiogenic shock, and failed PCI were predictors of early mortality.

U2 - 10.1016/j.jcin.2021.05.007

DO - 10.1016/j.jcin.2021.05.007

M3 - SCORING: Journal article

C2 - 34294400

VL - 14

SP - 1578

EP - 1590

JO - JACC-CARDIOVASC INTE

JF - JACC-CARDIOVASC INTE

SN - 1936-8798

IS - 14

ER -