Transcatheter aortic valve implantation after previous coronary artery bypass grafting: a potential gold standard of care

504 G. Ducrocq et al. / European Journal of Cardio-Thoracic Surgery Conflicts of interest: D.H. is Proctor physician for Edwards Lifesciences and Medtronic Inc. B.I. received consultant fees from Servier, Boehringer Ingelheim, Bayer, Valtech and Abbott, and speaker’s fees from Edwards Lifesciences, St. Jude Medical and Sanofi-Aventis. P.N. is Proctor physician for Edwards Lifesciences, consultant for Medtronic Inc and St Jude. A.V. received consultant fees/honoraria from Abbott, Edwards Lifesciences, Medtronic, Valtech. REFERENCES EDITORIAL COMMENT European Journal of Cardio-Thoracic Surgery 41 (2012) 504–505 doi:10.1093/ejcts/ezr164 Advance Access publication 21 December 2011 Transcatheter aortic valve implantation after previous coronary artery bypass grafting: a potential gold standard of care Thorsten Drews* Deutsches Herzzentrum Berlin, Berlin, Germany * Corresponding author. Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Tel: +49-30-45932076; fax: +49-331-8673784; email: (T. Drews). Keywords: Valves • Aortic valve • Transcatheter aortic valve implantation • TAVI • Re-operation • CABG Ducrocq et al. [1] present in their article the results of 201 patients undergoing transcatheter aortic valve implantation (TAVI). The group was divided into 54 patients with previous coronary artery bypass grafting (CABG) and 147 without. The [1] Fighali SF, Avendano A, Elayda MA, Lee VV, Hernandez C, Siero V et al. Early and late mortality of patients undergoing aortic valve replacement after previous coronary artery bypass graft surgery. Circulation 1995;92: II163–8. [2] Odell JA, Mullany CJ, Schaff HV, Orszulak TA, Daly RC, Morris JJ. Aortic valve replacement after previous coronary artery bypass grafting. Ann Thorac Surg 1996;62:1424–30. [3] Verhoye JP, Merlicco F, Sami IM, Cappabianca G, Lecouls H, Corbineau H et al. 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J Am Coll Cardiol 2010;55:1080–90. [21] Leon MB, Piazza N, Nikolsky E, Blackstone EH, Cutlip DE, Kappetein AP et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials a consensus report from the valve academic research consortium. Eur Heart J 2011;32:205–17. sign of incomplete myocardial revascularization? As already emphasized, I believe not only that TAVI can be safely performed in patients with previous CABG, but also that TAVI combined with PCI should be performed to treat the most significant coronary lesion(s) that could put at jeopardy large myocardial areas [6]. As shown by Ducrocq et al. [1], TAVI is an attractive option in the population of high-risk patients with aortic stenosis and previous CABG. Future studies will show whether TAVI will become the ‘gold standard of care’ in all patients after previous heart surgery. ACKNOWLEDGEMENT The members of our TAVI team are Miralem Pasic, Semih Buz, Axel Unbehaun, Giuseppe D’Ancona, Stephan Dreysse, Christoph Klein, Marian Kukucka, Alexander Mladenow and Roland Hetzer. REFERENCES [1] Ducrocq G, al Attarb N, Himberta D, Messika-Zeitouna D, Lung B, Descouturesa F et al. Early and mid-term outcomes in patients undergoing transcatheter aor (...truncated)