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Updated: Sep 28, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Transcatheter aortic valve replacement complications: A narrative review for emergency clinicians
Sam G Rouleau1, William J Brady2, Alex Koyfman3
1Department of Emergency Medicine, UC Davis Health, Sacramento, CA, United States.
Introduction:
Aortic valve stenosis (AS) is present in up to 10% of individuals over age 80 years. Transcatheter aortic valve replacement (TAVR) has become the most common method to replace the aortic valve in patients with AS. TAVR-related complications may occur.
Objective:
This narrative review evaluates the emergency department (ED) assessment and management of patients with TAVR complications.
Discussion:
Post-TAVR complications can be conceptualized as occurring peri-procedurally and after the peri-procedural period. Peri-procedural complications include device landing zone rupture, coronary artery obstruction, acute myocardial infarction, cardiac tamponade, and valve embolization. Complications beyond the peri-procedural window include vascular access/bleeding, mechanical valve issues, electrical conduction complications, and end-organ damage.
Conclusions:
Emergency clinicians are more likely to encounter TAVR complications after the initial procedural hospitalization and must be prepared to diagnose and manage these complications.
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