Why is this study important?

The decision to perform routine percutaneous coronary intervention (PCI) prior to transaortic valve replacement (TAVR) has been controversial, with little data driving the conversation.

What question was this study supposed to answer?

FAITAVI looks to answer the question of angiography-guided PCI versus physiologic assessment-guided PCI in patients who will undergo the TAVR procedure.

What did the study show?

Coronary artery disease is widely prevalent in patients undergoing TAVR, with most lesions found to be in the intermediate range. Three hundred twenty-one patients were randomized in 1:1 fashion to angiography-guided PCI vs fractional flow rate (FFR)-guided PCI (FFR <0.8).

In this small subset of patients undergoing TAVR, there was a significant reduction in combined major adverse cardiac events in patients who had an FFR-guided approach. Interestingly, in this cohort, the rates were driven by less death from any cause.

This data adds to the growing literature supporting a more conservative approach to PCI in patients undergoing the TAVR procedure.