EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
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Review Meta Analysis
Emergent cardiac surgery during transcatheter aortic valve implantation (TAVI): a weighted meta-analysis of 9,251 patients from 46 studies.
Transcatheter aortic valve implantation (TAVI) is a novel treatment option for high surgical risk patients with severe symptomatic aortic valve (AV) stenosis. During TAVI, some patients may require emergent cardiac surgery (ECS). However, the incidence, reasons and outcomes of those needing ECS remain unknown. ⋯ Reported rates of ECS during TAVI were low with embolisation or dislocation of the prosthesis being the most common cause. ECS was associated with grave prognosis with two out of three patients dying by 30 days. Thus, refinement in TAVI technology should not only focus on miniaturisation and improving flexibility of the delivery systems and/or devices -which may have the potential for decreasing aortic dissection, annular rupture, and tamponade- but also incorporate modifications to prevent embolisation/dislocation of the valve.