TY - JOUR
T1 - Emergent Conversion to Open Heart Surgery during Transcatheter Aortic Valve Implantation
T2 - The Presence of a Rescue Team Improves Outcomes
AU - Nasso, Giuseppe
AU - Vignaroli, Walter
AU - Contegiacomo, Gaetano
AU - Marchese, Alfredo
AU - Fattouch, Khalil
AU - D’Alessandro, Pasquale
AU - Brigiani, Mario Siro
AU - Vitobello, Vincenza
AU - Triggiani, Vera
AU - Demola, Maria Antonietta
AU - Tonioni, Stefano
AU - Paparella, Domenico
AU - Sechi, Stefano
AU - Bonifazi, Raffaele
AU - Santarpino, Giuseppe
AU - Resta, Fabrizio
AU - Bartolomucci, Francesco
AU - Lorusso, Roberto
AU - Larosa, Claudio
AU - Valenti, Giovanni
AU - Tito, Antonio
AU - Moscarelli, Marco
AU - Margari, Vito
AU - Fiore, Flavio
AU - Condello, Ignazio
AU - Speziale, Giuseppe
N1 - Funding Information:
This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Objective: Transcatheter aortic valve implant (TAVI) is the gold standard for the high-surgical-risk group of patients with aortic valve disease and it is an alternative to surgery in patients at intermediate risk. Lethal complications can occur, and many of these are manageable only with emergent conversion to open heart surgery. We retrospectively evaluate the outcome of all patients undergoing TAVI in our departments and the impact of a complete cardiac rescue team to reduce 30-day mortality. Methods: Data from all patients undergoing TAVI between January 2020 and August 2023 in our center were analyzed. An expert complete rescue was present in catheter laboratory. Primary outcomes were in-hospital and at 30-day mortality and evaluation of all cases needed for emergent conversion to open heart surgery. Results: 825 patients were enrolled. The total mortality was 19/825 (2.3%). Eleven of the total patients (1.3%) required emergent conversion to open heart surgery. Among them, eight were alive (73%), with a theoretical decrease of 0.98% in overall mortality. Conclusions: surgical treatment is rare during TAVI. The presence of an expert complete rescue team as support means an increase in survival. Surgery must be used only to restore circulatory and to treat complication while percutaneous approaches should complete the procedure.
AB - Objective: Transcatheter aortic valve implant (TAVI) is the gold standard for the high-surgical-risk group of patients with aortic valve disease and it is an alternative to surgery in patients at intermediate risk. Lethal complications can occur, and many of these are manageable only with emergent conversion to open heart surgery. We retrospectively evaluate the outcome of all patients undergoing TAVI in our departments and the impact of a complete cardiac rescue team to reduce 30-day mortality. Methods: Data from all patients undergoing TAVI between January 2020 and August 2023 in our center were analyzed. An expert complete rescue was present in catheter laboratory. Primary outcomes were in-hospital and at 30-day mortality and evaluation of all cases needed for emergent conversion to open heart surgery. Results: 825 patients were enrolled. The total mortality was 19/825 (2.3%). Eleven of the total patients (1.3%) required emergent conversion to open heart surgery. Among them, eight were alive (73%), with a theoretical decrease of 0.98% in overall mortality. Conclusions: surgical treatment is rare during TAVI. The presence of an expert complete rescue team as support means an increase in survival. Surgery must be used only to restore circulatory and to treat complication while percutaneous approaches should complete the procedure.
KW - cardiac surgery
KW - conversion to open heart surgery
KW - heart team
KW - TAVI
U2 - 10.3390/jcm12247705
DO - 10.3390/jcm12247705
M3 - Article
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 24
M1 - 7705
ER -