The impact of significant coronary lesions at the time of transcatheter aortic-valve replacement (TAVR) is contradictory according to the literature. Management of these lesions remains controversial before TAVR.

To compare the prognosis of TAVR patients without coronary disease with the prognosis of TAVR patients with significant coronary lesions, and to evaluate the impact of coronary angioplasty prior to TAVR.

We performed a retrospective monocenter study including patients with severe aortic stenosis who received TAVR between January 1, 2014 and December 31, 2016. The endpoints were based on those defined by the Valve Academic Research Consortium in addition to the duration of hospitalization for valve replacement.

340 patients were included, with a median follow-up time of 13 months (IQR: 9.75 to 19 months). They were divided in 3 groups: 223 (65.5%) in the group without coronary lesion (no CAD), 63 (18.5%) in the group with significant coronary lesions at the pre-TAVR coronary angiography and coronary angioplasty (CAD+PCI) and 54 (16%) in the group with significant coronary lesions medically managed (CAD no PCI). No CAD and CAD no PCI groups were compared on one hand, and CAD+PCI and CAD no PCI groups on the other hand. We reported no difference regarding the different endpoints, either between the no CAD and CAD no PCI groups or between CAD+PCI and CAD no PCI, whether we considered the 30-day all-cause mortality (6.7% vs. 3.7%, P=0.539) and (6.3% vs. 3.7%, P=0.685), or the one-year mortality (31.3% vs. 35.1%, P=0.627) and (30.1% vs. 35.1%, P=0.692) respectively. Kaplan–Meier survival curves were similar, with log-rank P=0.635 and log-rank P=0.892 respectively according to the comparison (Fig. 1).

The presence of significant coronary lesions before TAVR does not seem associated with poor prognosis. The conservative strategy, i.e. optimal medical treatment, may be a suitable option.