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Related Concept Videos

Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

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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...
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Mitral Stenosis III: Medical Management01:26

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Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Related Experiment Video

Updated: May 2, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

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Can TAVI be performed without on-site cardiac surgery?

V Lodo1, C Barbero2, S Salizzoni3

  • 1Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy.

International Journal of Cardiology. Heart & Vasculature
|July 16, 2025
PubMed
Summary

Emergent cardiac surgery (ECS) during transcatheter aortic valve implantation (TAVI) is rare (0.74%) but manageable. On-site surgical teams are crucial for improving patient outcomes and reducing mortality in TAVI procedures.

Keywords:
Emergent cardiac surgeryOn-site cardiac surgeryTAVI

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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure for aortic stenosis.
  • Intra-procedural complications can necessitate emergent cardiac surgery (ECS).
  • The role of on-site surgical teams in managing these complications is critical.

Purpose of the Study:

  • To assess the prevalence of surgical bailout during TAVI.
  • To evaluate post-procedural outcomes in patients requiring ECS after TAVI.
  • To determine the impact of on-site cardiac surgery on TAVI outcomes.

Main Methods:

  • A retrospective analysis of 1347 patients undergoing transfemoral TAVI between September 2017 and March 2023.
  • Data collected from two high-volume centers with on-site cardiac surgery.
  • Primary endpoint: in-hospital mortality after ECS. Secondary endpoints: intra-operative and 1-year mortality, and complications like AKI, stroke, MI, and LBBB.

Main Results:

  • Ten patients (0.74%) required ECS due to complications including aortic dissection, annulus rupture, and ventricular perforation.
  • Four patients needed post-operative inotropic support; one experienced stroke and one AKI (grade III).
  • In-hospital mortality was low (one case), with median ICU and hospital stays of 4.5 and 14 days, respectively.

Conclusions:

  • On-site cardiac surgery with a dedicated surgical team is a vital resource for TAVI centers.
  • This setup is essential for managing emergent complications effectively.
  • The presence of an on-site surgical team contributes to achieving low in-hospital mortality rates in TAVI patients requiring ECS.