Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2021; 13(8): 361-371
Published online Aug 26, 2021. doi: 10.4330/wjc.v13.i8.361
Role of coronary angiogram before transcatheter aortic valve implantation
Benjamin Beska, Divya Manoharan, Ashfaq Mohammed, Rajiv Das, Richard Edwards, Azfar Zaman, Mohammad Alkhalil
Benjamin Beska, Divya Manoharan, Ashfaq Mohammed, Rajiv Das, Richard Edwards, Azfar Zaman, Mohammad Alkhalil, Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, United Kingdom
Author contributions: Alkhalil M was conceptualized; Mohammed A, Das R, Edwards R, Zaman A, and Alkhalil M were investigated; Beska B, Manoharan D, and Alkhalil M are responsible for the methodology and project management; Alkhalil M carried out data processing and software formal analysis; Beska B, Manoharan D, Mohammed A, Das R, Edwards R, Zaman A, and Alkhalil M are responsible for the resources; Beska B and Alkhalil M were responsible for the preparation of the first draft; all authors have written reviews and edited.
Institutional review board statement: The current analysis was based on a clinical audit on the work up of transcatheter aortic valve implantation with focus on invasive coronary angiography. Ethical review was waived as part of the audit process and all collected data were anonymised during the analysis
Informed consent statement: The informed consent statement was waived.
Conflict-of-interest statement: Nothing to disclose.
Data sharing statement: Data are available from the corresponding authors on a reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammad Alkhalil, DPhil, MRCP, Doctor, Cardiothoracic Centre, Freeman Hospital, Freeman Road, Newcastle-upon-Tyne NE7 7DN, United Kingdom. mak-83@hotmail.com
Received: March 21, 2021
Peer-review started: March 21, 2021
First decision: May 5, 2021
Revised: May 26, 2021
Accepted: July 16, 2021
Article in press: July 16, 2021
Published online: August 26, 2021
ARTICLE HIGHLIGHTS
Research background

Routine coronary revascularisation pre-transcatheter aortic valve implantation (TAVI) was not associated with improved outcomes, yet, coronary angiogram (CA) is still performed as part of TAVI work up.

Research motivation

The lack of data showing consistent benefits in pre-TAVI revascularisation challenges the need for routine invasive coronary angiogram before TAVI procedure.

Research objectives

To assess whether a selective approach to perform pre-TAVI CA is safe and feasible.

Research methods

Retrospective analysis of consecutive patients undergoing TAVI who underwent CA vs those who did not was performed. Decision to undergo CA pre-TAVI was tailored to patients clinical characteristics.

Research results

The primary endpoint was a composite of all-cause mortality, myocardial infraction, repeat CA, and re-admission with heart failure was comparable between the two groups.

Research conclusions

Selective CA is a feasible and safe approach. The clinical value of routine CA should be challenged in future randomised trials.

Research perspectives

Future randomised clinical trials are required to test whether selective CA is safe.