Skip to main content
SpringerLink
Log in

Complications After Transcatheter Aortic Valve Implantation: an Updated Umbrella Review

  • Cardiovascular Care (L Roever, Section Editor)
  • Published:
Current Emergency and Hospital Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We conducted a comprehensive and updated overview on complications occurring after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis.

Recent Findings

Despite remarkable improvements in patient selection, devices, procedures, and ancillary management, complications may still occur in patients undergoing TAVI. On top of most commonly described adverse events such as death, myocardial infarction, stroke, bleeding, vascular complication, renal failure, pacemaker implantation and residual valve regurgitation, other less common but similarly severe complications may still occur. These may include events ranging from acute delirium to valve compression during cardiopulmonary resuscitation. Meticulous care should be applied to all screening and procedural steps for TAVI, and attentive follow-up should be implemented afterwards, especially in suboptimal TAVI candidates or those otherwise at high operative risk.

Summary

Despite recent remarkable improvements, additional research is warranted in order to further improve early and late outlook of TAVI, identify predictors of complications, and the best way to handle them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. •• Giordano A, Biondi-Zoccai G, Frati G, editors. Transcatheter aortic valve implantation: clinical, interventional, and surgical perspectives. Cham: Springer International Publishing; 2019. Comprehensive textbook on transcatheter aortic valve implantation.

    Google Scholar 

  2. Gatto L, Biondi-Zoccai G, Romagnoli E, Frati G, Prati F, Giordano A. New-generation devices for transcatheter aortic valve implantation. Minerva Cardioangiol. 2018;66:747–61.

    Article  Google Scholar 

  3. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2017;38:2739–91.

    Article  Google Scholar 

  4. Giordano A, Corcione N, Biondi-Zoccai G, Berti S, Petronio AS, Pierli C, et al. Patterns and trends of transcatheter aortic valve implantation in Italy: insights from RISPEVA. J Cardiovasc Med (Hagerstown). 2017;18:96–102.

    Article  Google Scholar 

  5. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002;106:3006–8.

    Article  Google Scholar 

  6. Dewey TM, Walther T, Doss M, Brown D, Ryan WH, Svensson L, et al. Transapical aortic valve implantation: an animal feasibility study. Ann Thorac Surg. 2006;82:110–6.

    Article  Google Scholar 

  7. Svensson LG, Dewey T, Kapadia S, Roselli EE, Stewart A, Williams M, et al. United States feasibility study of transcatheter insertion of a stented aortic valve by the left ventricular apex. Ann Thorac Surg. 2008;86:46–54.

    Article  Google Scholar 

  8. Lichtenstein SV, Cheung A, Ye J, Thompson CR, Carere RG, Pasupati S, et al. Transapical transcatheter aortic valve implantation in humans: initial clinical experience. Circulation. 2006;114:591–6.

    Article  Google Scholar 

  9. Webb JG, Pasupati S, Humphries K, Thompson C, Altwegg L, Moss R, et al. Percutaneous transarterial aortic valve replacement in selected high-risk patients with aortic stenosis. Circulation. 2007;116:755–63.

    Article  Google Scholar 

  10. Zeeshan A, Tuzcu EM, Krishnaswamy A, Kapadia S, Mick S. Transcatheter aortic valve replacement: history and current indications. Cleve Clin J Med. 2015;82:S6–10.

    Article  Google Scholar 

  11. •• Biondi-Zoccai G, Peruzzi M, Abbate A, Gertz ZM, Benedetto U, Tonelli E, et al. Network meta-analysis on the comparative effectiveness and safety of transcatheter aortic valve implantation with CoreValve or Sapien devices versus surgical replacement. Heart Lung Vessel. 2014;6:232–43. First ever network meta-analysis on transcatheter aortic valve implantation.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, Søndergaard L, Mumtaz M, et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2017;376(14):1321–31.

    Article  Google Scholar 

  13. Biondi-Zoccai G, editor. Umbrella reviews: evidence synthesis with overviews of reviews and meta-epidemiologic studies. Cham: Springer International Publishing; 2016.

    Google Scholar 

  14. • Kappetein AP, Head SJ, Généreux P, Piazza N, van Mieghem NM, Blackstone EH, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. Eur Heart J. 2012;33:2403–18. Key guideline on definitions for complications and adverse events in patients undergoing transcatheter aortic valve implantation.

    Article  Google Scholar 

  15. Giordano A, Corcione N, Ferraro P, Morello A, Conte S, Bedogni F, et al. Impact of predilation before transcatheter aortic valve implantation with new-generation devices. Cardiovasc Revasc Med. https://doi.org/10.1016/j.carrev.2019.01.017.

  16. Giordano A, Corcione N, Ferraro P, Pieri P, Avellino R, Frati G, et al. Propensity-score-adjusted comparison of Evolut vs. Portico devices for transcatheter aortic valve implantation. J Cardiovasc Med (Hagerstown). 2019;20:351–7. https://doi.org/10.2459/JCM.0000000000000764.

    Article  Google Scholar 

  17. Sun Y, Liu X, Chen Z, Fan J, Jiang J, He Y, et al. Meta-analysis of predictors of early severe bleeding in patients who underwent transcatheter aortic valve implantation. Am J Cardiol. 2017;120:655–61.

    Article  Google Scholar 

  18. Ma M, Gao WD, Gu YF, Wang YS, Zhu Y, He Y. Clinical effects of acute kidney injury after transcatheter aortic valve implantation: a systematic review and meta-analysis. Intern Emerg Med. 2019;14:161–75.

    Article  Google Scholar 

  19. Auffret V, Regueiro A, Del Trigo M, Abdul-Jawad Altisent O, Campelo-Parada F, Chiche O, et al. Predictors of early cerebrovascular events in patients with aortic stenosis undergoing transcatheter aortic valve replacement. J Am Coll Cardiol. 2016;68:673–84.

    Article  Google Scholar 

  20. Abawi M, Pagnesi M, Agostoni P, Chiarito M, van Jaarsveld RC, van Dongen CS, et al. Postoperative delirium in individuals undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis. J Am Geriatr Soc. 2018;66:2417–24.

    Article  Google Scholar 

  21. Marullo AGM, Biondi-Zoccai G, Giordano A, Frati G. No guts, no glory for aortic stenosis: impact of liver function on patients undergoing trascatheter aortic valve implantation. J Cardiovasc Med (Hagerstown). 2019;20:245–7.

    Article  Google Scholar 

  22. Ando T, Briasoulis A, Telila T, Afonso L, Grines CL, Takagi H. Does mild paravalvular regurgitation post transcatheter aortic valve implantation affect survival? A meta-analysis. Catheter Cardiovasc Interv. 2018;91:135–47.

    Article  Google Scholar 

  23. Rojas P, Amat-Santos IJ, Cortés C, Castrodeza J, Tobar J, Puri R, et al. Acquired aseptic Intracardiac shunts following Transcatheter aortic valve replacement: A Systematic Review. JACC Cardiovasc Interv. 2016;9:2527–38.

    Article  Google Scholar 

  24. • Mylotte D, Andalib A, Thériault-Lauzier P, Dorfmeister M, Girgis M, Alharbi W, et al. Transcatheter heart valve failure: a systematic review. Eur Heart J. 2015;36:1306–27. Comprehensive review on causes and mechanisms of transcatheter aortic valve implantation failure.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Dr. Robert Sherwin for reviewing their manuscript.

Author information

Authors and Affiliations

  1. Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy

    Alberto Morello, Nicola Corcione & Arturo Giordano

  2. Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy

    Paolo Farraro & Sirio Conte

  3. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100, Latina, Italy

    Giuseppe Biondi-Zoccai, Giacomo Frati, Mariangela Peruzzi & Elena Cavarretta

  4. Mediterranea Cardiocentro, Naples, Italy

    Giuseppe Biondi-Zoccai, Mariangela Peruzzi & Elena Cavarretta

  5. IRCCS NEUROMED, Pozzilli, Italy

    Giacomo Frati

  6. Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy

    Barbara Antonazzo

  7. Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil

    Leonardo Roever

  8. Department of Cardiology, University of Catania, Catania, Italy

    Antonio Popolo Rubbio

  9. Department of Cardiology, University of Verona, Verona, Italy

    Magdalena Cuman

Authors
  1. Alberto Morello
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicola Corcione
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paolo Farraro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sirio Conte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giuseppe Biondi-Zoccai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giacomo Frati
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Barbara Antonazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mariangela Peruzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Elena Cavarretta
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Leonardo Roever
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Antonio Popolo Rubbio
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Magdalena Cuman
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Arturo Giordano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giuseppe Biondi-Zoccai.

Ethics declarations

Conflict of Interest

Prof. Biondi-Zoccai has consulted for Abbott Vascular and Bayer. Alberto Morello, Nicola Corcione, Paolo Farraro, Sirio Conte, Giacomo Frati, Barbara Antonazzo, Mariangela Peruzzi, Elena Cavarretta, Leonardo Roever, Antonio Popolo Rubbio, Magdalena Cuman, and Arturo Giordano declare interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Cardiovascular Care

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morello, A., Corcione, N., Farraro, P. et al. Complications After Transcatheter Aortic Valve Implantation: an Updated Umbrella Review. Curr Emerg Hosp Med Rep 7, 227–233 (2019). https://doi.org/10.1007/s40138-019-00202-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40138-019-00202-4

Keywords

Search

Navigation