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Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation

OBJECTIVE: The aim of this study was to evaluate the reasons for emergent cardiac surgery (ECS) after transcatheter aortic valve implantation (TAVI) and assess outcomes of these patients. METHODS: All patients undergoing ECS following a complicated TAVI procedure at a high-volume TAVI centre in the...

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Autores principales: van Steenbergen, Gijs J., Olsthoorn, Jules R., Eerdekens, Rob, Tan, Erwin, Tonino, Pim A. L., Lam, Ka Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bohn Stafleu van Loghum 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10667165/
https://www.ncbi.nlm.nih.gov/pubmed/37917382
http://dx.doi.org/10.1007/s12471-023-01820-0
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author van Steenbergen, Gijs J.
Olsthoorn, Jules R.
Eerdekens, Rob
Tan, Erwin
Tonino, Pim A. L.
Lam, Ka Yan
author_facet van Steenbergen, Gijs J.
Olsthoorn, Jules R.
Eerdekens, Rob
Tan, Erwin
Tonino, Pim A. L.
Lam, Ka Yan
author_sort van Steenbergen, Gijs J.
collection PubMed
description OBJECTIVE: The aim of this study was to evaluate the reasons for emergent cardiac surgery (ECS) after transcatheter aortic valve implantation (TAVI) and assess outcomes of these patients. METHODS: All patients undergoing ECS following a complicated TAVI procedure at a high-volume TAVI centre in the Netherlands from 1 January 2008 to 1 April 2022 were included. Baseline and procedural characteristics and outcome data (procedural, 30-day and 1‑year mortality, in-hospital stroke, 30-day pacemaker implantation, 30-day vascular complications, 30-day deep sternal wound infections and 30-day re-exploration) were collected from patient files and analysed using descriptive statistics. RESULTS: During the study period, 16 of 1594 patients (1.0%) undergoing TAVI required ECS. The main reason for ECS was valve embolisation (n = 9; 56.3%), followed by perforation of the left/right ventricle with guide wire/pacemaker lead (n = 3; 18.8%) and annular rupture (n = 3; 18.8%). Procedural, 30-day and 1‑year mortality was 0%, 18.8% (n = 3) and 31.3% (n = 5), respectively. In-hospital stroke occurred in 1 patient (6.3%), a pacemaker was implanted at 30 days in 2 patients (12.5%), and major vascular complications did not occur. CONCLUSION: ECS following complicated TAVI was performed in only a small number of cases. It had a high but acceptable perioperative and 30-day mortality, taking into account the otherwise lethal consequences. In case of valve embolisation, no periprocedural or 30-day mortality was observed for surgical aortic valve replacement (even in a redo setting), which supported the necessity to perform TAVI in centres with cardiac surgical backup on site.
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spelling pubmed-106671652023-11-02 Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation van Steenbergen, Gijs J. Olsthoorn, Jules R. Eerdekens, Rob Tan, Erwin Tonino, Pim A. L. Lam, Ka Yan Neth Heart J Original Article OBJECTIVE: The aim of this study was to evaluate the reasons for emergent cardiac surgery (ECS) after transcatheter aortic valve implantation (TAVI) and assess outcomes of these patients. METHODS: All patients undergoing ECS following a complicated TAVI procedure at a high-volume TAVI centre in the Netherlands from 1 January 2008 to 1 April 2022 were included. Baseline and procedural characteristics and outcome data (procedural, 30-day and 1‑year mortality, in-hospital stroke, 30-day pacemaker implantation, 30-day vascular complications, 30-day deep sternal wound infections and 30-day re-exploration) were collected from patient files and analysed using descriptive statistics. RESULTS: During the study period, 16 of 1594 patients (1.0%) undergoing TAVI required ECS. The main reason for ECS was valve embolisation (n = 9; 56.3%), followed by perforation of the left/right ventricle with guide wire/pacemaker lead (n = 3; 18.8%) and annular rupture (n = 3; 18.8%). Procedural, 30-day and 1‑year mortality was 0%, 18.8% (n = 3) and 31.3% (n = 5), respectively. In-hospital stroke occurred in 1 patient (6.3%), a pacemaker was implanted at 30 days in 2 patients (12.5%), and major vascular complications did not occur. CONCLUSION: ECS following complicated TAVI was performed in only a small number of cases. It had a high but acceptable perioperative and 30-day mortality, taking into account the otherwise lethal consequences. In case of valve embolisation, no periprocedural or 30-day mortality was observed for surgical aortic valve replacement (even in a redo setting), which supported the necessity to perform TAVI in centres with cardiac surgical backup on site. Bohn Stafleu van Loghum 2023-11-02 2023-12 /pmc/articles/PMC10667165/ /pubmed/37917382 http://dx.doi.org/10.1007/s12471-023-01820-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/ Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
van Steenbergen, Gijs J.
Olsthoorn, Jules R.
Eerdekens, Rob
Tan, Erwin
Tonino, Pim A. L.
Lam, Ka Yan
Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation
title Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation
title_full Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation
title_fullStr Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation
title_full_unstemmed Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation
title_short Outcomes of emergent cardiac surgery after transcatheter aortic valve implantation
title_sort outcomes of emergent cardiac surgery after transcatheter aortic valve implantation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10667165/
https://www.ncbi.nlm.nih.gov/pubmed/37917382
http://dx.doi.org/10.1007/s12471-023-01820-0
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