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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Published on: December 11, 2017

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Atrioventricular and intraventricular block after transcatheter aortic valve implantation

Jane J Lee1, Nora Goldschlager1, Vaikom S Mahadevan2

  • 1University of California San Francisco, San Francisco, CA, USA.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|June 25, 2018
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) can cause conduction abnormalities like atrioventricular (AV) and intraventricular (IV) block. This review examines the anatomy, clinical aspects, and management of these common TAVR complications.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Interventional Cardiology

Background:

  • Aortic stenosis is a prevalent valvular heart disease causing left ventricular outflow tract (LVOT) obstruction.
  • Transcatheter aortic valve replacement (TAVR) is a key treatment for severe symptomatic aortic stenosis in high-risk patients.
  • Conduction system abnormalities, specifically atrioventricular (AV) and intraventricular (IV) block, are frequent complications post-TAVR.

Purpose of the Study:

  • To review the anatomical considerations pertinent to AV block following TAVR.
  • To discuss the clinical and procedural factors associated with AV and IV block after TAVR.
  • To explore the management strategies and long-term outcomes of conduction disturbances post-TAVR.

Main Methods:

  • Literature review focusing on anatomical variations.
  • Analysis of clinical data and procedural techniques.
  • Synthesis of current evidence on management and prognosis.

Main Results:

  • Detailed anatomical insights into the conduction system relative to the aortic valve.
  • Identification of procedural elements influencing the risk of AV and IV block.
  • Overview of diagnostic approaches and therapeutic interventions for conduction abnormalities.

Conclusions:

  • Understanding the anatomical substrate is crucial for mitigating TAVR-related conduction blocks.
  • Careful procedural execution and patient selection can reduce complication rates.
  • Effective management strategies are essential for improving long-term outcomes in patients experiencing AV and IV block post-TAVR.

Keywords:
Atrioventricular blockIntraventricular blockPacemaker implantationTranscatheter aortic valve implantation

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