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The safety of concomitant percutaneous coronary intervention (PCI) during transcatheter aortic valve implantation (TAVI) setting is still highly debated. This study aimed to assess the safety and the effectiveness of TAVI and PCI performed in the same session compared with TAVI alone.Patients with severe aortic stenosis and coronary artery disease (CAD) (n=786) who underwent TAVI from June 2007 to April 2021 were divided into two groups: patients who underwent TAVI alone (n=633) and patients treated with TAVI and concomitant PCI (n=153). The propensity-score matching adjustment was used to account for baseline confounding variables.A total of 302 TAVI with CAD patients (151 matched pairs), undergoing either isolated TAVI or TAVI+PCI were compared. In-hospital death (6% vs 4%; p=0.427), stroke (2% vs 0.7%; p=0.314), myocardial infarction (MI) (0% vs 0.7%; p=0.317), major and life-threatening bleeding (14.6% vs 15.9%; p=0.749), and acute kidney injury (9.3% vs 10.6%; p=0.700) were similar for both groups. At 3 years, the rates of all-cause death (25.2% vs 19.2%; p=0.615), the composite endpoints of all-cause death and MI (27.2% vs 21.2%; p=0.699) and all-cause death, MI, and stroke (28.5% vs 22.5%; p=0.739) were also comparable between the two groups. Achieving complete coronary revascularization in the TAVI setting did not impact on long-term mortality (p=0.257).In patients with severe aortic stenosis and CAD, concomitant TAVI and PCI was as safe and effective as TAVI alone up to 3-year follow-up.

BACKGROUND: Aim of this study was to assess the potential differences in respecting the principles of goal-directed perfusion between aortic valve replacement with sutureless vs. conventional stented bioprostheses.METHODS: Data from 94 consecutive patients undergoing aortic valve replacement with Perceval sutureless valve, with or without concomitant coronary artery bypass grafting, were compared to a contemporary cohort of 116 patients receiving conventional stented bioprostheses. Propensity score matching was used to reduce selection bias. Flow-dependent estimate of oxygen delivery and carbon dioxide production were compared in accordance to the principles of goal directed perfusion. Hospital outcomes were assessed as well.RESULTS: Propensity score matching resulted in 39 pairs with similar characteristics and operative risk. Cross-clamping time (41.6 +/- 20.6 vs. 89.6 +/- 48.2; P