Publications by authors named "D J van Ginkel"
Objectives: Screening for obstructive coronary artery disease (CAD) with coronary computed tomography angiography (CCTA) could prevent unnecessary invasive coronary angiography (ICA) procedures during work-up for trans-catheter aortic valve implantation (TAVI). CT-derived fractional flow reserve (CT-FFR) improves CCTA accuracy in chest pain patients. However, its reliability in the TAVI population is unknown.
View Article and Find Full Text PDFBackground: Concomitant coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). The optimal treatment strategy for CAD is a topic of debate. An initial conservative strategy for CAD in patients undergoing TAVI may be favorable as multiple studies have failed to show an evident beneficial effect of percutaneous coronary intervention (PCI) on mortality after TAVI.
View Article and Find Full Text PDFTransCatheter aortic valve implantation and fractional flow reserve-guided percutaneous coronary intervention versus conventional surgical aortic valve replacement and coronary bypass grafting for treatment of patients with aortic valve stenosis and complex or multivessel coronary disease (TCW): an international, multicentre, prospective, open-label, non-inferiority, randomised controlled trial.
Lancet
December 2025
Background: Patients with severe aortic stenosis present frequently (∼50%) with concomitant obstructive coronary artery disease. Current guidelines recommend combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) as the preferred treatment. Transcatheter aortic valve implantation (TAVI) and fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) represent a valid treatment alternative.
View Article and Find Full Text PDFArticle Synopsis
- - The study evaluated the safety and efficacy of using an upper-extremity approach for secondary access during transfemoral transcatheter aortic valve implantation (TAVI) compared to the traditional lower-extremity method, as it may reduce significant bleeding risks.
- - Conducted between November 2022 and November 2023 in the Netherlands, the TAVI XS trial involved 238 patients with severe aortic stenosis, who were randomly assigned to either the upper or lower access groups.
- - Results showed that the upper-extremity approach had a lower incidence of clinically relevant bleeding (4.2% vs. 13.4% for the lower extremity), suggesting it could be a safer option for patients undergoing
Article Synopsis
- Major or life-threatening bleeding and stroke are complications that can occur after transcatheter aortic valve implantation (TAVI), impacting both mortality and quality of life (QoL).
- Major bleeding increases the risk of death significantly, while minor bleeding does not affect mortality; however, both types of bleeding and stroke lead to lower mental QoL scores.
- The study highlights that monitoring these complications is essential, as they correlate with poorer mental well-being in patients during the first year post-TAVI.