The Current Situation and the Future of Emergent Cardiac Surgery in TAVI

Transcatheter aortic valve implantation (TAVI) has become a beneficial treatment for patients with aortic valve stenosis deemed at high or even prohibitive risk for open surgery. The risk for severe complications is low (ranging between 0.2 % and 1.0 %); nevertheless, in approximately 1 % of patients emergency cardiac surgery (ECS) is required during TAVI. Aortic injury, embolization of the TAVI prosthesis, and myocardial injury are among the most frequent complications necessitating ECS. Mortality rates of ECS during TAVI are high, ranging between 45 % and 67 %, owing to the comorbid and fragile health status of TAVI patients. Therefore, avoidance of complications appears to be of utmost importance to improve outcomes. This review analysis the current literature in terms of incidence, causes, and outcomes of ECS during TAVI.