Reported Causes of Device Embolization Following Transcatheter Aortic Valve Replacement: A Systematic Review and...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Device Technology

Background:

• Transcatheter aortic valve replacement (TAVR) is a common treatment for aortic valve stenosis.
• Prosthetic valve embolization (PVE) is a rare, severe complication of TAVR.
• Previous data on PVE prevalence and risk factors require updated systematic review.

Purpose of the Study:

• To determine the prevalence of post-TAVR prosthetic valve embolization.
• To identify risk factors associated with TAVR device embolization.
• To analyze clinical outcomes and management strategies for PVE.

Main Methods:

• Updated systematic review of contemporary studies (2014-2024) on TAVR device embolization.
• Inclusion of studies reporting embolization events and clinical outcomes.
• Pooled event rates calculated using the random effects method.

Main Results:

• 34 studies reported 501 cases of device embolization, with a prevalence of 1.4%.
• Embolization predominantly occurred intraprocedurally (80%).
• PVE significantly increased mortality (18-20% at 30 days, ~30% at 1 year) and often required surgical conversion (61%).

Conclusions:

• Prosthetic valve embolization is a rare but significant complication of TAVR.
• The complication necessitates aggressive management due to high associated mortality and procedural complexity.
• While the overall population risk is low, PVE poses a serious threat to individual patients.