[Prosthesis embolization during transcatheter aortic valve implantation]

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Transcatheter aortic valve implantation (TAVI) is a revolutionary treatment for severe aortic stenosis.
• Device embolization is a rare but serious complication during TAVI, with significant morbidity and mortality.
• Current data on predictors and management of TAVI device embolization are limited.

Purpose of the Study:

• To review the incidence and outcomes of percutaneous prosthesis embolization during TAVI.
• To identify predictors and preventive measures for device embolization.
• To propose an integrated management algorithm for TAVI device embolization.

Main Methods:

• Review of existing literature on TAVI device embolization.
• Analysis of data from registries like TRAVEL.
• Synthesis of information on clinical presentation, risk factors, and management strategies.

Main Results:

• Device embolization occurs in approximately 1% of TAVI procedures, leading to increased morbidity and mortality.
• Clinical manifestations range from incidental findings to cardiogenic shock.
• Management depends on device type, location, timing, and patient condition.

Conclusions:

• Device embolization during TAVI, though rare, is a preventable complication requiring careful procedural planning and risk factor awareness.
• An integrated algorithmic approach combining percutaneous and surgical techniques is advisable for managing device embolization.
• Increased awareness of predisposing factors and bail-out options is crucial for structural interventionalists.