Coronary artery disease and aortic stenosis in the transcatheter aortic valve replacement era: old questions, new paradigms: the evolving role of percutaneous coronary intervention in the treatment of patients with aortic stenosis.

Significant coronary artery disease (CAD) is present in up to 50% of patients with symptomatic aortic stenosis (AS). Although numerous databases have shown that the addition of bypass grafting to an aortic valve replacement (AVR) nearly doubles the mortality, surgical series have shown that leaving significant coronary stenosis untreated increases AVR mortality.1–4 Thus, the standard of care for this population has been concomitant coronary artery bypass grafting along with surgical aortic valve replacement.