Incidence, Management, and Outcomes of Cardiac Tamponade During Transcatheter Aortic Valve Implantation

Abstract

Cardiac tamponade during TAVI is not frequent but is associated with high mortality rates especially when left-sided structures are involved. Meticulous handling of the equipment and improvements in the safety of currently used devices could further reduce the occurrence of this complication.

Perioperative Results and Complications in 15,964 Transcatheter Aortic Valve Replacements

“…At present these risks vary between 3 and 8 percent, depending on the risk profiles of the patients, the overall clinical experience of the teams, and the type of analyses, i.e. whether they are calculated for selected trials or all-comers experiences (11)(12)(13)(14)(15). The overall assessment of a relatively new therapeutic procedure like T-AVI should be based on populationwide results, which can only be gathered by specific clinical registries.…”

Trans-catheter aortic valve implantation: Contemporary practice and the future

“…Traumatic left or right ventricular injury usually manifests itself with pericardial effusion and tamponade. The rate of pericardial effusion and tamponade peri-TAVI is reported to be around 4% [23,24]. Of note, in a series of cases, only 4 (23.5% of all causes of tamponade) were attributed to direct left ventricular wire perforation [24].…”

Transcatheter aortic valve implantation: technique, complications and perspectives

“…Furthermore, periprocedural complications such as low cardiac output, major vascular complications, acute kidney injury and stroke seem to have a major role in acute mortality and in mortality occurring during the 1-year follow-up period [10,11,13,17,33,46,[99][100][101]. Lastly, cardiac tamponade due to transient pacemaker and/or stiff wire-related perforations must be promptly observed and swiftly handled in this fragile elderly population, where mortality is very high when conversion to open heart surgery is necessary [102].…”

“…Cardiac tamponade during TAVI is not frequent where the incidence ranges from 0 to 7% [3,5,9,102], but is associated with high mortality rates, especially when left-sided structures are involved. Unexplained hypotension should prompt the consideration for cardiac tamponade.…”

“…Typically, pericardiocentesis is adequate; however, thoracotomy might be required, especially if left-sided structures are involved. Meticulous handling of the equipment and improvements in the safety of currently used devices could further reduce the occurrence of this complication [102].…”