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  11. Can Tavi Be Performed Without On-site Cardiac Surgery?

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

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View abstract on PubMed

Summary
This summary is machine-generated.

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.

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.
Keywords:
Emergent cardiac surgeryOn-site cardiac surgeryTAVI

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  • 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.