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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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The Conjunction Conundrum in Transcatheter Aortic Valve Implantation

Andreas Mitsis1, Christos Eftychiou1, Theodoros Christophides1

  • 1Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus.

Current Problems in Cardiology
|February 3, 2022
PubMed

Insights

Predictors for permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) are reviewed, focusing on modifiable technical factors. Understanding these factors is crucial as TAVI expands to lower-risk patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Transcatheter aortic valve implantation (TAVI) is increasingly used in low and intermediate-risk patients.
  • Permanent pacemaker implantation (PPI) following TAVI remains a significant concern.
  • Predictors and pathophysiology of post-TAVI conduction abnormalities require ongoing investigation.

Purpose of the Study:

  • To review current data on pathophysiology, risk factors, and indications for PPI after TAVI.
  • To identify potentially modifiable factors contributing to conduction abnormalities post-TAVI.
  • To inform clinical practice as TAVI adoption broadens.

Main Methods:

  • Systematic review of existing literature on TAVI and PPI.
  • Analysis of factors contributing to rhythm abnormalities post-TAVI.
  • Categorization of risk factors into pre-existing, patient-related, and peri-procedural.

Main Results:

  • Conduction abnormalities post-TAVI stem from pre-existing conditions, patient anatomy, and procedural techniques.
  • Peri-procedural technical factors are potentially modifiable and warrant focused attention.
  • The expansion of TAVI to lower-risk populations necessitates a deeper understanding of PPI predictors.

Conclusions:

  • Modifiable peri-procedural factors are key targets for reducing PPI rates after TAVI.
  • Further research into optimizing TAVI techniques is essential.
  • Careful patient selection and procedural management can mitigate risks associated with TAVI.

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