Transcatheter aortic valve replacement complications: A narrative review for emergency clinicians

Rouleau, Samuel G.; Brady, William J.; Koyfman, Alex; Long, Brit

doi:10.1016/j.ajem.2022.03.042

Cited by 17 publications

(8 citation statements)

References 130 publications

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“…The utilization of a valve‐in‐valve approach during the acute phase for the treatment of TAVR‐induced Gerbode defects is a valuable learning point from this case report, offering a minimally invasive solution and avoiding the need for more invasive surgical interventions. While additional research is needed to establish optimal management strategies for TAVR‐induced Gerbode defects, our case provides valuable insights into the potential efficacy of a valve‐in‐valve approach in the acute phase, highlighting the importance of considering alternative treatment options for rare complications encountered during TAVR 3,4 …”

Section: Discussionmentioning

confidence: 96%

“…While additional research is needed to establish optimal management strategies for TAVR-induced Gerbode defects, our case provides valuable insights into the potential efficacy of a valve-in-valve approach in the acute phase, highlighting the importance of considering alternative treatment options for rare complications encountered during TAVR. 3,4…”

Section: Discussionmentioning

confidence: 99%

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Successful closure of transcatheter aortic valve replacement‐induced Gerbode defect with valve‐in‐valve technique: A case report

Skalidis,

Hamilos,

Petousis

et al. 2023

Cathet Cardio Intervent

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We present the first documented case of a successful closure of a transcatheter aortic valve replacement (TAVR)‐induced Gerbode defect using a valve‐in‐valve approach. A 90‐year‐old female with severe aortic stenosis underwent TAVR. Following post‐dilatation, the patient experienced hemodynamic deterioration and collapse due to tamponade and sub‐annular rupture leading to hemodynamic deterioration and the development of a Gerbode defect with communication between the left ventricle and right atrium. Hemodynamic stabilization was achieved through pericardiocentesis, followed by the low implantation of a second valve, effectively sealing the rupture. This case showcases a valuable alternative for managing rare challenging complications during TAVR procedures.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Successful closure of transcatheter aortic valve replacement‐induced Gerbode defect with valve‐in‐valve technique: A case report

Skalidis,

Hamilos,

Petousis

et al. 2023

Cathet Cardio Intervent

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“…To identify the most prevalent complications following aortic valve replacement, we referred to existing literature. [11][12][13][14] Subsequently, we included these complications in our analysis exclusively if they possessed specific ICD-10-CM/PCS codes that had been validated in prior research. Other relevant variables included sociodemographic variables such as age, gender, race, median annual income quartiles specific to the patient's ZIP code, as well as hospital-related factors including region, bed size, and teaching status.…”

Section: Outcome Measures and Study Variablesmentioning

confidence: 99%

A Comparative Analysis of In-Hospital Outcomes and Care Cost Between Surgical and Transcatheter Valve Replacement for Aortic Stenosis: Insights From the U.S Nationwide Inpatient Sample Database

Uwumiro,

Bojerenu,

Ogbodo

et al. 2023

Preprint

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Background/objectivesTranscatheter aortic valve replacement (TAVR) has emerged as a preferred alternative to surgical aortic valve replacement (SAVR) for symptomatic aortic stenosis. This study aimed to compare the clinical outcomes and care costs of TAVR and SAVR to medical management using five years of inpatient data.MethodsAdult hospitalizations with a principal diagnosis of aortic stenosis were analyzed from the Nationwide Inpatient Sample database (2016-2020). Diagnosis and procedure variables, as well as confounders and comorbidities, were identified using the International Classification of Diseases (ICD-10) codes. Multivariable regression models were utilized to assess mortality odds, length of stay (LOS), periprocedural complications, and care costs.ResultsAmong the 364,515 admissions for aortic stenosis analyzed, the mean age was 76 ± 0.5 years, with a majority of male patients (57.8%) and White Americans comprising 85.5% of the population. SAVR was performed in 29.3% of cases, and TAVR in 50.8%. TAVR demonstrated significantly lower in-hospital mortality compared to SAVR (aOR: 0.463; 95% CI: 0.366-0.587; P < 0.001), whereas SAVR did not show a significant difference (aOR: 0.786; 95% CI: 0.601-1.029; P = 0.079). TAVR also resulted in a significantly shorter mean LOS compared to SAVR (adjusted mean LOS: 2.37; 95% CI: 2.12-2.63; P < 0.001 vs. 6.25; 95% CI: 6.00-6.50; P < 0.001). While TAVR patients had a lower likelihood of complications, they incurred higher hospital costs.ConclusionTAVR demonstrated significantly lower odds of in-hospital mortality and shorter length of stay compared to medical management or SAVR. However, TAVR patients incurred higher hospital costs despite a lower likelihood of complications.

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“…TAVR is recommended especially in patients with severe AS who are at least 75 years old, have high risk, or are not suitable for surgery [3]. Despite advances in procedure, periprocedural complications are still common and related to morbidity and mortality [4].…”

Section: Introductionmentioning

confidence: 99%

Is dynamic change in mean platelet volume related with composite endpoint development after transcatheter aortic valve replacement?

Ince,

Gulsen,

Ozcan

et al. 2023

Blood Coagulation &Amp; Fibrinolysis

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Aortic valve stenosis (AS) is the most common valvular disease, and surgical or transcatheter aortic valve replacement (TAVR) are the treatment options. Diminish in platelet production or dysfunction may occur due to shear stress, advanced age, and other coexisting diseases in AS patients. Bleeding is one of the complications of TAVR and associated with increased mortality. MPV (mean platelet volume) indicates platelet's thrombogenic activity. Overproduction or consumption of platelets in various cardiac conditions may affect MPV values. We aimed to investigate the pre and postprocedure MPV percentage change (MPV-PC) and its association with post-TAVR short-term complications. A total of 204 patients who underwent TAVR with a diagnosis of severe symptomatic AS were included. The mean age was 78.66 ± 6.45 years, and 49.5% of patients were women. Two groups generated according to composite end point (CEP) development: CEP(+) and CEP(-).110 patients(53.9%) formed CEP(+) group. Although baseline MPV and platelet levels were similar between groups, MPV was increased (P < 0.001) and platelet was decreased (P < 0.001) significantly following the procedure when compared to baseline. MPV-PC was significantly higher in the VARC type 2–4 bleeding (P = 0.036) and major vascular, access-related, or cardiac structural complication groups (P = 0.048) when CEP subgroups were analyzed individually. Regression analysis revealed that diabetes mellitus [P = 0.044, β: 1.806 odds ratio (95% confidence interval): 1.016–3.21] and MPV-PC [P = 0.007,β: 1.044 odds ratio (95% confidence interval): 1.012–1.077] as independent predictors of CEP development at 1 month after TAVR. The MPV increase following TAVR may be an indicator of adverse outcomes following TAVR procedure within 1-month.

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Transcatheter aortic valve replacement complications: A narrative review for emergency clinicians

Cited by 17 publications

References 130 publications

Successful closure of transcatheter aortic valve replacement‐induced Gerbode defect with valve‐in‐valve technique: A case report

Successful closure of transcatheter aortic valve replacement‐induced Gerbode defect with valve‐in‐valve technique: A case report

A Comparative Analysis of In-Hospital Outcomes and Care Cost Between Surgical and Transcatheter Valve Replacement for Aortic Stenosis: Insights From the U.S Nationwide Inpatient Sample Database

Is dynamic change in mean platelet volume related with composite endpoint development after transcatheter aortic valve replacement?

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