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Transcatheter heart valve failure: a systematic review
Darren Mylotte1, Ali Andalib2, Pascal Thériault-Lauzier2
1Department of Interventional Cardiology, McGill University Health Centre, Montreal, QC, Canada Department of Cardiology, Galway University Hospital, Galway, Ireland.
European Heart Journal
|October 1, 2014
Summary
Transcatheter heart valves (THV) can fail due to endocarditis, structural issues, or thrombosis, similar to surgical valves. Novel failures include late embolization and compression, requiring specific management strategies.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Innovation
Background:
- Transcatheter heart valve (THV) failure modes require comprehensive understanding.
- Existing literature lacks a detailed description of THV failure aetiology, diagnosis, management, and outcomes.
Purpose of the Study:
- To systematically review and describe the causes, diagnosis, treatment, and outcomes of transcatheter heart valve failure.
- To identify novel failure modes unique to THV devices.
Main Methods:
- Systematic review conducted adhering to PRISMA guidelines.
- Searched EMBASE, MEDLINE, and Scopus databases for relevant publications.
- Analyzed 70 publications reporting 87 cases of transcatheter aortic valve implantation (TAVI) failure between December 2002 and March 2014.
Main Results:
- Common failure modes included prosthetic valve endocarditis (PVE) (n=34), structural valve failure (n=13), and THV thrombosis (n=15).
- Novel THV failures identified: late THV embolization (n=18) and THV compression (n=7), not reported in surgical literature.
- THV embolization often necessitated surgery (80%), while thrombosis was successfully managed with anticoagulation in 75% of cases.
Conclusions:
- Transcatheter heart valves exhibit failure modes similar to surgical bioprostheses, alongside unique complications.
- Late THV embolization and compression are novel failure modes specific to THV design and implantation.
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