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Related Concept Videos

Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...

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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

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Published on: February 8, 2022

Emergent Cardiac Surgery After Transcatheter Structural Heart Procedures: Narrative Review.

Miriam Compagnone1, Gianni Dall'Ara1,2, Simone Grotti1

  • 1Interventional and Structural Cardiovascular Unit, Forlì-Cesena, AUSL Romagna, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|April 8, 2025
PubMed
Summary

Emergent cardiac surgery (ECS) after transcatheter structural heart procedures is rare (<0.5%) due to improved techniques and expertise. However, outcomes for patients needing ECS remain poor, highlighting the need for careful planning and collaboration.

Keywords:
emergent cardiac surgeryleft atrial appendage occlusiontranscatheter aortic valve replacementtranscatheter edge‐to‐edge repair

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Surgical Innovation

Background:

  • Transcatheter structural heart procedures are standard for high-risk elderly patients.
  • These procedures have increased globally, with fewer major complications.
  • Emergent cardiac surgery (ECS) rates have declined due to advancements.

Purpose of the Study:

  • To provide a comprehensive analysis of ECS following major percutaneous structural procedures.
  • To address fragmented data on the incidence and management of ECS.
  • To offer an updated overview of bailout surgery for procedural complications.

Main Methods:

  • Analysis of emergent cardiac surgery (ECS) rates after transcatheter aortic valve replacement, mitral valve repair/replacement, and left atrial appendage occlusion.
  • Review of multicenter studies and literature on procedural complication management.
  • Focus on the first comprehensive analysis of ECS following these specific procedures.

Main Results:

  • Emergent cardiac surgery (ECS) after transcatheter structural interventions is now very rare (<0.5%).
  • Most major complications are managed percutaneously, reducing the need for ECS.
  • Outcomes for patients requiring ECS remain unfavorable despite optimal settings.

Conclusions:

  • A collaborative Heart Team approach and advanced imaging are crucial for minimizing adverse events.
  • Despite low incidence, understanding ECS remains important for patient safety.
  • Technological advancements and expertise have significantly reduced ECS rates.