What is the latest in the management of coronary artery disease in TAVI candidates?

Ole De Backer and Daniel Blackman discuss the management of coronary artery disease in TAVI candidates and whether PCI should be performed before valve implantation or safely deferred.

They review PROTAVI, which supports a selective strategy with PCI only when clinically indicated, with a signal toward less bleeding and no clear penalty for deferral.

They contrast this with NOTION-3, which suggests a potential benefit of more systematic revascularisation before TAVI, though interpretation is influenced by differences in study design and endpoint definitions.

Overall, the discussion supports an individualised approach based on coronary disease burden, bleeding risk, and clinical presentation.

They also address the role of angina symptoms and whether valve treatment should remain the first step, with coronary reassessment after TAVI in selected cases.

This interview was filmed at EuroPCR 2026: see more videos here.