Percutaneous aortic valve implantation in patients with coronary artery disease: review of therapeutic strategies.

The optimal treatment for coronary artery disease in patients who are candidates for percutaneous aortic valve implantation (PAVI) remains unclear. The operating team should take into consideration that the symptoms of ischemic heart disease could be identical to those of severe aortic stenosis and that performing percutaneous coronary intervention (PCI) in these frail patients prior to, or following PAVI, is not trivial. We describe a patient with severe aortic stenosis and significant coronary artery disease who was treated during the same interventional session: PCI that was followed immediately by PAVI. We review the different treatment strategies for patients who are candidates for PAVI and have coronary artery disease, discuss the relative advantages of each approach, and propose an algorithm for their treatment.