Post TAVI Coronary REVASCularisation Guided by Myocardial Perfusion Imaging: a Prospective Open Label Pilot Study: The REVASC-TAVI Study

Launched by UNIVERSITY HOSPITAL, MONTPELLIER · Jun 7, 2016

Keywords

ClinConnect Summary

Background: Percutaneous coronary intervention (PCI) is usually proposed to patients with aortic stenosis (AS) before TransAortic Valve Implantation (TAVI) when significant coronary stenosis is detected on preprocedural coronary angiography. However, the benefit of a systematic revascularisation is unknown and may have specific complications in elderly and frail patients.

Aims: The investigators proposed a strategy of selected revascularization guided on myocardial ischemia detection after the TAVI procedure by using single photon emission computed tomography (SPECT) myocardial perfusion i...

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Eligibility criteria

• Inclusion Criteria:
• • Patients older than 18 years
• • Severe and symptomatic aortic stenosis defined as a median trans-valvular gradient higher than 40 mmHg and an aortic valve area of less than 1.0 cm2 or 0,6 cm2/m2 on echocardiography associated to significant CAD defined by ≥1 stenosis of ≥70% in a major epicardial coronary artery or ≥50% for left main
• • Patients is not candidate for surgical aortic valve replacement after the multidisciplinary heart team decision.
• Exclusion Criteria:
• • Recent acute coronary syndrome (within 30 days before randomization),
• • Unprotected left main disease
• • Critical stenosis (\>90%) of Left Anterior Descending artery (LAD),
• • Significant angina (CCS class more than 2)
• • Active bleeding,
• • Contraindication for tomographic technetium-99 assessment or dipyridamole injection
• • Previous enrollment in a other study
• • Impossibly to obtain consent