Aortic valve replacement plus revascularization: The battle of surgical versus transcatheter approach still rages.

The current guidelines for primary aortic valve disease suggest, with different class of recommendation, concomitant coronary artery revascularization in all candidates to aortic valve replacement with angiographic evidence of significant coronary artery diameter stenosis (≥70%, ≥50% for left main stenosis) both for surgical or transcatheter approach. Initial (non-patient-level) pooled data analyses suggest that a percutaneous transcatheter approach confers similar outcomes compared to a surgical approach in patients with severe AS and CAD. Further scientific evidences from RCTs are warranted to clarify the prognostic impact of CAD on TAVR candidates and to identify the most appropriate revascularization strategy.