Key result
Cardiac surgery after transcatheter aortic valve replacement is associated with high 30-day mortality rates ranging from 8.5% to 25.8%, which is often double the predicted operative risk.
Why the study?
With expanding TAVR applications into lower-risk patients, the incidence of surgical re-interventions for long-term complications or catastrophic periprocedural events is growing.
As TAVR expands to lower-risk patients, the incidence of post-TAVR cardiac surgery is expected to grow, presenting complex technical challenges and high mortality that require specialized Heart Team management.
Answers are grounded in this paper and cite their sources.
High mortality after post-TAVR surgical re-intervention warrants specialized Heart Team evaluation; leaves open optimal strategies as TAVR expands.
With broadening applications of transcatheter aortic valve replacement (TAVR) and increasing use in intermediate- and low-risk patients, the incidence of surgical re-interventions after TAVR is growing. Transcatheter heart valves suffer from similar long-term complications as surgical heart valve prostheses that require surgical re-intervention, including endocarditis and structural valve deterioration. Catastrophic periprocedural complications - such as annular or aortic rupture requiring urgent surgical intervention - may also occur during TAVR procedures. This review summarizes the current knowledge on indications, methods, and outcomes of cardiac operations after TAVR, with a focus on how to improve results in a rapidly growing patient population.
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Mazur et al. (2023) conducted a review in Aortic stenosis and post-TAVR complications. Cardiac surgery after TAVR was evaluated. Cardiac surgery after transcatheter aortic valve replacement is associated with high 30-day mortality rates ranging from 8.5% to 25.8%, which is often double the predicted operative risk.
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