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Transcatheter Aortic Valve Implantation

Review of the Nature, Management, and Avoidance of Procedural Complications

Jean-Bernard Masson, MD^_*, Jan Kovac, MD, Gerhard Schuler, MD, Jian Ye, MD^_*, Anson Cheung, MD^_*, Samir Kapadia, MD, Murat E. Tuzcu, MD, Susheel Kodali, MD^||, Martin B. Leon, MD^||, John G. Webb, MD^_*,_*

^_* Divisions of Cardiology and Cardiac Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
Department of Cardiology, University Hospitals, Leicester, United Kingdom
Department of Cardiology, Heart Center, Leipzig, Germany
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
^|| Center for Interventional Vascular Therapy, Columbia University Medical Center, New York, New York

^_* Reprint requests and correspondence: Dr. John G. Webb, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada (Email: webb{at}providencehealth.bc.ca).

Transcatheter aortic valve implantation (TAVI) is becoming a reality in the management of patients with severe aortic stenosis and high or prohibitive risk for standard surgical management. Current understanding of the potential adverse events associated with this procedure is limited. Risks associated with TAVI differ from those related to surgical valve replacement and include vascular injury; stroke; cardiac injury such as heart block, coronary obstruction, and cardiac perforation; paravalvular leak; and valve misplacement. The clinical experience of multiple centers experience with different valve implantation systems and techniques was reviewed. Awareness of how complications occur might help in their avoidance, recognition, and management. Ultimately, improved understanding of the potential complications associated with TAVI might help improve outcomes and allow wider application of this therapy.

Key Words: aortic valve • catheter • complication

Abbreviations and Acronyms   LV = left ventricle/ventricular   TAVI = transcatheter aortic valve implantation