Complete Functional Assessment of Intermediate Coronary Artery Stenosis Before and After Transcatheter Aortic Valve Implantation (TAVI) in Patients With Severe Symptomatic Aortic Valve Stenosis

Inclusion Criteria:

• Age >18 years

• Willing to participate and able to understand, read and sign the informed consentdocument before the planned procedure

• Severe symptomatic aortic stenosis with indication for TAVI according to currentguidelines deemed by the Heart Team

• Patients who have undergone coronary CT angiography before TAVI in which CAD couldnot be ruled out

• CAD in one or more native major epicardial vessels or their branches by coronaryangiogram with visually assessed coronary stenosis, in which the physiologicalseverity of the lesion is in question (typically 40-90% diameter stenosis).

• Eligible for invasive coronary angiography and functional assessment (FFR, RFR, CFRand IMR)

• Eligible for coronary CT-angiography and functional assessment (CT-FFR)

Exclusion Criteria:

• Patients whose CT-angiography was determined to be non-diagnostic/unreadable duringits evaluation

• Previous coronary artery bypass grafting with patent grafts to the interrogatedvessel

• Patients with severe lesions with a diameter stenosis ≥ 90%, flow-limiting lesions,or a significant left main coronary artery stenosis

• Critical coronary artery disease deemed by the Heart Team to require immediaterevascularization

• Contraindication to adenosine (e.g. bronchial asthma)

• Chronic renal impairment with severe reduction of glomerular filtration rate (eGFR <30 ml/min)

• Presence of cardiogenic shock

• Participation in another interventional study involving the left heart or coronaryarteries