Complications After Transcatheter Aortic Valve Implantation

Margolina, Anna; Gruzdev, K A; Лепилин, М Г; Tabakyan, E. A.; Имаев, Т. Э.; Акчурин, Р. С.

doi:10.18565/cardio.2016.2.35-39

Cited by 5 publications

(2 citation statements)

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“… 32 In addition, Margolina et al in their study of 99 patients who underwent TAVI in a single center in Russia stated hemopericardium, with an incidence of 6%, among the main complications after TAVI, without giving information whether this condition led to cardiac tamponade. 33 …”

Section: Discussionmentioning

confidence: 99%

Factors associated with early cardiac complications following transcatheter aortic valve implantation with transapical approach

Patris

Giakoumidakis

Argiriou

et al. 2018

POR

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PurposeTo estimate the incidence of postprocedural early cardiac complications among patients undergoing transcatheter aortic valve implantation, through transapical approach (TA-TAVI), and to identify factors independently associated with the occurrence of them.Patients and methodsA retrospective cohort study of 90 patients, who had undergone TA-TAVI in a tertiary hospital of Liverpool, UK, during a 5-year period (September 2008–October 2013), was conducted. Data on patient demographics, periprocedural characteristics and cardiac complications presented within 30-day post TA-TAVI were collected, retrospectively, using the hospital’s electronic database.ResultsThe overall 30-day incidence of cardiac complications was estimated at 18.9% (n=17/90). The rate of new onset of atrial fibrillation (AF), atrioventricular block requiring permanent pacemaker implantation, shockable cardiac arrest rhythm and cardiac tamponade was 11.1%, 3.3%, 2.2% and 2.2%, respectively. Bivariate analysis found that absence of preoperative AF (p=0.01), receiving of oral inotropes preprocedurally (p=0.01), intravenous inotropic support postprocedurally (p=0.01) and requirement for postprocedural tracheal intubation (p=0.001) were the main factors associated with increased probability for patient cardiac morbidity.ConclusionIt seems that patients with absence of AF and oral inotropic support preprocedurally and those with post TA-TAVI mechanical ventilatory and intravenous inotropic support have greater probability to develop cardiac complications. This knowledge allows the early identification of high-risk patients and supports clinicians to apply both preventive and therapeutic interventions for the optimum patient management and care. In addition, administrators could allocate the health care system resources effectively.

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Section: Discussionmentioning

confidence: 99%

Factors associated with early cardiac complications following transcatheter aortic valve implantation with transapical approach

Patris

Giakoumidakis

Argiriou

et al. 2018

POR

View full text Add to dashboard Cite

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“…По литературным оценкам, с момента первой успешной TAVI в 2002 году более 100 000 пациентов во всем мире были подвергнуты данной процедур, в том числе России [4,5]. Однако, несмотря на клинический успех, практический опыт демонстрирует TAVI-обусловленные осложнения, наиболее важными из которых являются послеоперационная параваскулярная регургитация, а также разрыв аортального корня, миграция протеза, возникновение атрио-вентрикулярных блокад [6,7]. Для клинических специалистов подобные осложнения трудно предсказать из-за необходимости анализа особенностей анатомии корня аорты пациента, геометрии модели протеза, учета размера и распределения кальциевых конгломератов, а также прогнозирования их расположения после вальвулопластики.…”

Section: Introductionunclassified

Simulation of Transcatheter Aortic Valve Implantation Procedure

Klyshnikov¹,

Ganyukov²,

Batranin³

et al. 2019

Math.Biol.Bioinf.

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The study is devoted to numerical modeling of transcatheter aortic valve implantation (TAVI) from the position of prognostic value in comparison with clinical data. The finite element method implemented in the Abaqus/CAE software and the reconstruction of three-dimensional models based on the computer microtomography of the CoreValve bioprosthesis of a size of 29 mm and the patient-specific data of functional studies (multispiral tomography) were used in the work. The study included three variations in the modeling of the aortic valve prosthesis procedure, which determine the level of detalization of the numerical experiment. All stages of the TAVI process were reproduced: the crimp of the prosthesis, the movement of the delivery system, the interaction of the guide - guidewire with the elements of the “prosthesis-root” of the aorta system, implantation itself. In silico experiment demonstrated significant quantitative and qualitative agreement with the data of intraoperative fluorography and computed tomography after the TAVI procedure. It is shown that the inclusion of additional elements – the guidewire and catheter of the delivery system into the “aortic root” has a positive effect on the convergence of the data with the clinical results. The analysis of the stress-strain state of the elements interacting in the experiment demonstrated a significant contribution to the analyzed parameters of the prosthetic motion stage along the guidewire as part of the delivery system catheter. Nevertheless, a comparison with the results of the clinical evaluation of the TAVI procedure revealed a number of differences in the response of the model of the bioprosthesis at the later stages of modeling, which requires further researches of a level of detalization. The approach is extremely promising both for practitioners and for research work of prosthetic designers, it can be applied in further R&D tasks.

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