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ISMICS 2026 Annual Meeting

10 - 13 June, 2026 | Miami, Florida

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P33

Hybrid Approach To Treat Concomitant Severe Coronary Artery Disease And Aortic Valve Stenosis

Part of Topic

Coronary Revascularization

OBJECTIVES

Severe coronary artery disease (CAD) is a common finding in patients with severe aortic valve stenosis (AS) scheduled for TAVI. While current guidelines recommends concomitant CABG and surgical AVR, this approach might be at high risk in fragile, elder patients. While benefits of a complete percutaneous revascularization concomitantly with TAVI is still debated, the only target providing a prognostic benefit seems to be the revascularization of the left anterior descending artery (LAD). However the complexity of the LAD lesions may provide suboptimal results when PCI is performed.

We report our experience in providing a combined HYBRID APPROACH by means of a minimally invasive revascularization strategies + TAVI for the treatment of concomitant CAD and severe AS.   

 

METHODS

Retrospective analysis of patients with severe LAD stenosis + AS scheduled for TAVI

 Inclusion criteria:

-Concomitant 2 procedures at high surgical risk (frailty, age, comorbidities or ESII >5)

-LAD stenosis at high risk for PCI (syntax >30) and suitable for surgical revascularization
 

CONCLUSIONS

This patient-tailored approach showed a high safety profile. A significant breakdown of the overall risk was guaranteed to fragile patients although the best treatment options were provided for both LAD revascularization, by means of a minimally invasive off-pump technique, as well as TAVI for AS in elderly. 

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