Key result
The presence of an expert cardiac rescue team during TAVI was associated with a 2.3% overall mortality rate and a 73% survival rate among patients requiring emergent conversion to open heart surgery.
Why the study?
Lethal complications during TAVI can require emergent conversion to open heart surgery, prompting evaluation of the impact of a complete cardiac rescue team on reducing 30-day mortality.
Does the presence of an expert complete cardiac rescue team improve survival in patients undergoing TAVI?
Cohort (n=825)
No
Does the presence of an expert complete cardiac rescue team improve survival in patients undergoing TAVI?
Answers are grounded in this paper and cite their sources.
The presence of a dedicated cardiac rescue team during TAVI can successfully manage rare but lethal complications requiring emergent open heart surgery, potentially reducing overall mortality.
OBJECTIVE: Transcatheter aortic valve implant (TAVI) is the gold standard for the high-surgical-risk group of patients with aortic valve disease and it is an alternative to surgery in patients at intermediate risk. Lethal complications can occur, and many of these are manageable only with emergent conversion to open heart surgery. We retrospectively evaluate the outcome of all patients undergoing TAVI in our departments and the impact of a complete cardiac rescue team to reduce 30-day mortality. METHODS: Data from all patients undergoing TAVI between January 2020 and August 2023 in our center were analyzed. An expert complete rescue was present in catheter laboratory. Primary outcomes were in-hospital and at 30-day mortality and evaluation of all cases needed for emergent conversion to open heart surgery. RESULTS: 825 patients were enrolled. The total mortality was 19/825 (2.3%). Eleven of the total patients (1.3%) required emergent conversion to open heart surgery. Among them, eight were alive (73%), with a theoretical decrease of 0.98% in overall mortality. CONCLUSIONS: surgical treatment is rare during TAVI. The presence of an expert complete rescue team as support means an increase in survival. Surgery must be used only to restore circulatory and to treat complication while percutaneous approaches should complete the procedure.
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Nasso et al. (2023) conducted a cohort in Aortic valve disease (n=825). Presence of a complete cardiac rescue team was evaluated on In-hospital and 30-day mortality and evaluation of all cases needed for emergent conversion to open heart surgery. The presence of an expert cardiac rescue team during TAVI was associated with a 2.3% overall mortality rate and a 73% survival rate among patients requiring emergent conversion to open heart surgery.
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