CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC 2022 17_9-10_21510.15836/ccar2022.215Extended AbstractValvular heart diseaseSurgical complications of transcatheter aortic valve implantationhttps://orcid.org/0000-0003-2740-4067UnićDaniel*https://orcid.org/0000-0002-3768-9134HadžibegovićIrzalhttps://orcid.org/0000-0001-9187-7681PavlovićNikolahttps://orcid.org/0000-0001-8652-4523ŠipićTomislavhttps://orcid.org/0000-0003-3962-2774PavlovMarinhttps://orcid.org/0000-0001-5690-9924KušurinMarkohttps://orcid.org/0000-0002-2637-9691JurinIvanahttps://orcid.org/0000-0001-5955-0275BarićDavorhttps://orcid.org/0000-0001-7125-361XBlažekovićRoberthttps://orcid.org/0000-0001-6602-699XVarvodićJosiphttps://orcid.org/0000-0001-6444-2674ManolaŠimehttps://orcid.org/0000-0002-7735-6721RudežIgorDubrava University Hospital, Zagreb, CroatiaADDRESS FOR CORRESPONDENCE: Daniel Unić, Klinička bolnica Dubrava, Av. G. Šuška 6, HR-10000 Zagreb, Croatia./ / Phone: +385-98-919-662 / E-mail: dunic@kbd.hr112022179-1021521503112022101120222022Croatian Cardiac SocietyKEYWORDS: mitral valvestructural deteriorationtranscatheter valve implantation
Goal: To present surgical complications in a cohort of patients treated with transcatheter aortic valve implantation (TAVI) in a single institution. Complications were reported according to Valve Academic Research Consortium-2 (VARC-2) criteria.
Patients and Methods: Since 11/2011 a total of 257 patients (139 male, 118 female) were treated with TAVI procedure. Average age was 78.6±7.3 years (30-91). Average Society of Thoracic Surgeons (STS) score was 5.4±3.8% (0.9-23.8). Self-expanding prosthesis was used in 98 and baloon expandable in 159 patients. Transfemoral approach was used in 243 (95%) of patients. Alternative access sites included transapical - 10, transaortic - 2 and subclavian - 2.
Results: Overall mortality was 2.3% (6/257). Most frequent complications requiring surgical intervention included peripheral access site complications 17/243 (7%). Bleeding was observed in 9/257 (3.5%) with cardiac tamponade in 6/257 patients – 1 requiring subxiphoid drainage. Valvular embolization was observed in 4/257 patients (2%) with 1 requiring surgical intervention. Conversion to open sternotomy was required in 3/257 (1%) – 2 annular rupture, 1 apical rupture with 2/3 patients expiring.
Conclusion: Complications of TAVI procedure that require surgical intervention are mostly related to vascular access site. Conversion to sternotomy is rare but yields a high mortality (1).
LITERATUREGrubeESinningJM. The “Big Five” Complications After Transcatheter Aortic Valve Replacement: Do We Still Have to Be Afraid of Them? . 2019 February 25;12(4):370–2. 10.1016/j.jcin.2018.12.01930784642