Complications of transcatheter aortic valve replacement and rescue attempts

Abstract

As a novel treatment modality, transcatheter aortic valve replacement (TAVR) is widely used for patients with severe aortic valve stenosis who have high surgical risk worldwide. However, this promising alternative procedure has different types of complication risks including, cerebrovascular events, vascular complications, bleeding, coronary obstruction, myocardial infarction, valve regurgitation, valve malpositioning or migration, conduction disturbances and acute kidney injury which may occur during and/or after the procedure. These complications may be seen up to one third of the patients and some of them may need urgent surgical intervention and may have a higher risk of death. For preventing and overcoming these complications, pre-procedural evaluation of the patient by an effective “heart team” which consists of cardiologists, cardiac surgeons, radiologists and anesthesiologists in equal proportion is needed. Estimating the potential difficulties and complications, deciding the interventions to be performed in case of any complication may increase the success of the procedure and save the patients’ lives. In this article, we reviewed the possible complications of the TAVR procedure and described rescue procedures in case of complications, in the context of the literature.

Keywords

Aortic valve stenosis / transcatheter aortic valve replacement / risk factors / complication / surgery / catheter

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