TY - JOUR
T1 - Incidence, management, and outcomes of cardiac tamponade during transcatheter aortic valve implantation
T2 - A single-center study
AU - Rezq, Ahmed
AU - Basavarajaiah, Sandeep
AU - Latib, Azeem
AU - Takagi, Kensuke
AU - Hasegawa, Tasuku
AU - Figini, Filippo
AU - Cioni, Micaela
AU - Franco, Annalisa
AU - Montorfano, Matteo
AU - Chieffo, Alaide
AU - Maisano, Francesco
AU - Corvaja, Nicola
AU - Alfieri, Ottavio
AU - Colombo, Antonio
PY - 2012/12
Y1 - 2012/12
N2 - Objectives: The aim of this study was to explore the incidence, causes, and outcomes of cardiac tamponade in patients undergoing transcatheter aortic valve implantation (TAVI). Background: Use of TAVI is increasing, but the procedure is vulnerable to complications, given the cohort of patients. Cardiac tamponade is a possible complication, and there is a scarcity of data on the incidence and outcomes of cardiac tamponade during TAVI. Methods: All patients who sustained cardiac tamponade during or post-TAVI between 2007 and 2012 were included in the study. Results: Of 389 patients who underwent TAVI, 17 (4.3%) had cardiac tamponade. The mean age was 82.3 ± 3.7 years, and most were women (n = 12, 70.6%). Causes of cardiac tamponade were right ventricular perforation by temporary pacemaker (9 patients, 52.9%), annular rupture or aortic dissection (4 patients, 23.5%), and tear in the left ventricular free wall caused by Amplatz stiff wire or catheters (4 patients, 23.5%). Mortality occurred in 4 patients (23.5%), and all had tamponade caused by injury to the high-pressured left-sided circulation (left ventricle and aorta). Most patients (n = 14, 82.4%) sustained cardiac tamponade during the procedure - 2 patients (11.7%) within 24 h, and 1 patient after 24 h. Conclusions: 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.
AB - Objectives: The aim of this study was to explore the incidence, causes, and outcomes of cardiac tamponade in patients undergoing transcatheter aortic valve implantation (TAVI). Background: Use of TAVI is increasing, but the procedure is vulnerable to complications, given the cohort of patients. Cardiac tamponade is a possible complication, and there is a scarcity of data on the incidence and outcomes of cardiac tamponade during TAVI. Methods: All patients who sustained cardiac tamponade during or post-TAVI between 2007 and 2012 were included in the study. Results: Of 389 patients who underwent TAVI, 17 (4.3%) had cardiac tamponade. The mean age was 82.3 ± 3.7 years, and most were women (n = 12, 70.6%). Causes of cardiac tamponade were right ventricular perforation by temporary pacemaker (9 patients, 52.9%), annular rupture or aortic dissection (4 patients, 23.5%), and tear in the left ventricular free wall caused by Amplatz stiff wire or catheters (4 patients, 23.5%). Mortality occurred in 4 patients (23.5%), and all had tamponade caused by injury to the high-pressured left-sided circulation (left ventricle and aorta). Most patients (n = 14, 82.4%) sustained cardiac tamponade during the procedure - 2 patients (11.7%) within 24 h, and 1 patient after 24 h. Conclusions: 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.
KW - TAVI
KW - TAVI complications
KW - tamponade in TAVI
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U2 - 10.1016/j.jcin.2012.08.012
DO - 10.1016/j.jcin.2012.08.012
M3 - Article
C2 - 23257375
AN - SCOPUS:84871259431
SN - 1936-8798
VL - 5
SP - 1264
EP - 1272
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 12
ER -