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Late Surgical Treatment for Transcatheter Aortic Valve Prosthesis Dysfunction
Pietro Giorgio Malvindi1, Roberto Lorusso2, Federica Jiritano3
1GVM Care & Research, Santa Maria Hospital, Bari, Italy.
The Annals of Thoracic Surgery
|September 26, 2020
Summary
Transcatheter aortic valve implantation (TAVI) prostheses can fail due to degeneration, thrombosis, or endocarditis. Surgical explant for TAVI failure showed 15% hospital mortality and 71% 2-year survival.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomaterials Science
Background:
- Transcatheter aortic valve implantation (TAVI) is a common procedure for aortic stenosis.
- Potential complications include structural valve degeneration, valve thrombosis, and infective endocarditis.
- Late surgical explant of TAVI prostheses is sometimes necessary to address these failures.
Observation:
- This study analyzed data from 13 patients who underwent late surgical explant of TAVI prostheses across 8 European centers.
- The primary reasons for explant were prosthetic infective endocarditis (6 patients), structural valve degeneration (4 patients), and valve thrombosis (3 patients).
Findings:
- Hospital mortality following surgical explant was 15%.
- Survival at the 2-year follow-up after explant surgery was 71%.
- These outcomes highlight the risks associated with TAVI prosthesis failure and subsequent surgical intervention.
Implications:
- These findings underscore the importance of monitoring TAVI patients for long-term complications.
- Further research may focus on improving TAVI prosthesis durability and reducing failure rates.
- Optimizing surgical management strategies for TAVI explant patients is crucial for improving prognoses.
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