Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy.
Department of Cardiovascular Surgery, Mount Sinai Health System, New York City, New York, USA.
J Card Surg. 2022 Jul;37(7):2053-2059. doi: 10.1111/jocs.16380. Epub 2022 Mar 6.
The proportion of patients with symptomatic severe aortic stenosis treated by transcatheter aortic valve replacement (TAVR) is increasing, driven by favorable outcomes from randomized trials and current valve guidelines recommendations. Despite device and technique improvements having reduced procedural morbidities, complications during or immediately after TAVR still carries significant mortality risk.
We propose a check-list of essential items to anticipate potentially life-threatening complications in TAVR.
Purpose of this review is to discuss the most common life-threatening complications during TAVR from a troubleshooting perspective, depicting the minimum required equipment needed in emergency situations.
Prevention of complications remains the most important strategy to optimize outcomes in TAVR procedures. Each specialized Center should institute and make easily accessible standardized emergency kits for the most common life-threatening conditions during TAVR that should be readily available in the cath-lab or hybrid operating room.
经随机试验和现行瓣膜指南推荐,经导管主动脉瓣置换术(TAVR)治疗有症状的重度主动脉瓣狭窄患者的比例不断增加。尽管器械和技术的改进降低了手术相关的发病率,但 TAVR 期间或之后立即发生的并发症仍存在显著的死亡风险。
我们提出了一份清单,列出了 TAVR 中可能危及生命的并发症的基本项目。
本综述的目的是从故障排除的角度讨论 TAVR 期间最常见的危及生命的并发症,并描述在紧急情况下所需的最低限度的必要设备。
预防并发症仍然是优化 TAVR 手术结果的最重要策略。每个专业中心都应制定并方便获取 TAVR 期间最常见危及生命情况的标准化急救包,这些急救包应在导管室或杂交手术室随时可用。