Department of Emergency Medicine, UC Davis Health, Sacramento, CA, United States.
Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.
Am J Emerg Med. 2022 Jun;56:77-86. doi: 10.1016/j.ajem.2022.03.042. Epub 2022 Mar 27.
Aortic valve stenosis (AS) is present in up to 10% of individuals over age 80 years. Transcatheter aortic valve replacement (TAVR) has become the most common method to replace the aortic valve in patients with AS. TAVR-related complications may occur.
This narrative review evaluates the emergency department (ED) assessment and management of patients with TAVR complications.
Post-TAVR complications can be conceptualized as occurring peri-procedurally and after the peri-procedural period. Peri-procedural complications include device landing zone rupture, coronary artery obstruction, acute myocardial infarction, cardiac tamponade, and valve embolization. Complications beyond the peri-procedural window include vascular access/bleeding, mechanical valve issues, electrical conduction complications, and end-organ damage.
Emergency clinicians are more likely to encounter TAVR complications after the initial procedural hospitalization and must be prepared to diagnose and manage these complications.
主动脉瓣狭窄（AS）在 80 岁以上的人群中发病率高达 10%。经导管主动脉瓣置换术（TAVR）已成为治疗 AS 患者主动脉瓣置换的最常见方法。TAVR 相关并发症可能会发生。
本综述叙述性评估了 TAVR 并发症患者的急诊科评估和管理。
TAVR 术后并发症可分为手术期间和手术期间后发生。手术期间并发症包括器械着陆区破裂、冠状动脉阻塞、急性心肌梗死、心脏压塞和瓣膜栓塞。手术期间后并发症包括血管入路/出血、机械瓣问题、电传导并发症和终末器官损伤。
急诊临床医生更有可能在初始手术住院后遇到 TAVR 并发症，必须做好诊断和处理这些并发症的准备。
