Management of complications after valvular interventions

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter valve interventions (TVIs) have revolutionized valvular heart disease management for high-risk surgical patients.
• Increasing utilization necessitates a comprehensive understanding of potential complications.
• Familiarity with rare complications and their management is crucial for optimal patient outcomes.

Purpose of the Study:

• To provide a state-of-the-art review of complications associated with key transcatheter valve interventions.
• To outline strategies for the prevention and management of these complications.
• To cover transcatheter aortic valve implantation (TAVI), mitral transcatheter edge-to-edge repair (M-TEER), and transcatheter mitral valve replacement (TMVR).

Main Methods:

• Systematic literature review of complications following TAVI, M-TEER, and TMVR.
• Synthesis of current evidence on complication incidence, mechanisms, and clinical impact.
• Expert consensus on best practices for prevention and management.

Main Results:

• Complications vary by procedure but can include vascular access issues, cardiac tamponade, device malposition, and paravalvular leak.
• Early recognition and appropriate management are key to mitigating adverse events.
• Preventive strategies involve careful patient selection, procedural planning, and advanced imaging.

Conclusions:

• Transcatheter valve interventions require vigilant monitoring for potential complications.
• Effective prevention and management strategies are essential for successful TAVI, M-TEER, and TMVR.
• This review serves as a critical resource for clinicians managing patients undergoing these advanced cardiac procedures.