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Cardiopulmonary Bypass and Cardiac Surgery in TAVR

  • A. Claire Watkins
  • Anuj Gupta
  • Bartley P. Griffith
Chapter

Abstract

Despite being minimally invasive, TAVR procedures come with significant procedural risk. In the high-risk TAVR patient, brief moments of instability can lead to cardiac arrest. Preparedness for procedural complications requires clear planning ahead of time. Below are tips to consider prior to an emergency.

Keywords

Sternotomy ECMO Cardiopulmonary bypass Pericardiocentesis Cardiac arrest Annular rupture Aortic injury Aortic dissection 

References

  1. 1.
    Walther T, Hamm CW, Schuler G, Berkowitsch A, Kötting J, Mangner N, Mudra H, Beckmann A, Cremer J, Welz A, Lange R, Kuck KH, Mohr FW, Möllmann H. GARY executive board. Perioperative results and complications in 15,964 Transcatheter aortic valve replacements: prospective data from the GARY registry. J Am Coll Cardiol. 2015;65(20):2173–80.CrossRefPubMedGoogle Scholar
  2. 2.
    Langer NB, Hamid NB, Nazif TM, Khalique OK, Vahl TP, White J, Terre J, Hastings R, Leung D, Hahn RT, Leon M, Kodali S, George I. Injuries to the aorta, aortic annulus, and left ventricle during Transcatheter aortic valve replacement: management and outcomes. Circ Cardiovasc Interv. 2017;10(1):pii: e004735.CrossRefGoogle Scholar
  3. 3.
    Pasic M, Unbehaun A, Buz S, Drews T, Hetzer R. Annular rupture during transcatheter aortic valve replacement: classification, pathophysiology, diagnostics, treatment approaches, and prevention. JACC Cardiovasc Interv. 2015;8(1 Pt A):1–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Barbanti M, Yang TH, Rodès Cabau J, Tamburino C, Wood DA, Jilaihawi H, Blanke P, Makkar RR, Latib A, Colombo A, Tarantini G, Raju R, Binder RK, Nguyen G, Freeman M, Ribeiro HB, Kapadia S, Min J, Feuchtner G, Gurtvich R, Alqoofi F, Pelletier M, Ussia GP, Napodano M, de Brito FS Jr, Kodali S, Norgaard BL, Hansson NC, Pache G, Canovas SJ, Zhang H, Leon MB, Webb JG, Leipsic J. Anatomical and procedural features associated with aortic root rupture during balloon-expandable transcatheter aortic valve replacement. Circulation. 2013;128(3):244–53.CrossRefPubMedGoogle Scholar
  5. 5.
    Drews T, Pasic M, Buz S, Dreysse S, Klein C, Kukucka M, Mladenow A, Hetzer R, Unbehaun A. Elective use of femoro-femoral cardiopulmonary bypass during transcatheter aortic valve implantation. Eur J Cardiothorac Surg. 2015;47(1):24–30.CrossRefPubMedGoogle Scholar
  6. 6.
    Singh V, Patel SV, Savani C, Patel NJ, Patel N, Arora S, Panaich SS, Deshmukh A, Cleman M, Mangi A, Forrest JK, Badheka A. Mechanical circulatory support devices and transcatheter aortic valve implantation (from the National Inpatient Sample). Am J Cardiol. 2015;116(10):1574–80.CrossRefPubMedGoogle Scholar
  7. 7.
    Shreenivas SS, Lilly SM, Szeto WY, Desai N, Anwaruddin S, Bavaria JE, Hudock KM, Thourani VH, Makkar R, Pichard A, Webb J, Dewey T, Kapadia S, Suri RM, Xu K, Leon MB, Herrmann HC. Cardiopulmonary bypass and intra-aortic balloon pump use is associated with higher short and long term mortality after transcatheter aortic valve replacement: a PARTNER trial substudy. Catheter Cardiovasc Interv. 2015;86(2):316–22.CrossRefPubMedGoogle Scholar
  8. 8.
    Drews T, Pasic M, Buz S, d'Ancona G, Dreysse S, Kukucka M, Mladenow A, Hetzer R, Unbehaun A. Transcatheter aortic valve implantation in very high-risk patients with EuroSCORE of more than 40. Ann Thorac Surg. 2013;95(1):85–93.CrossRefPubMedGoogle Scholar
  9. 9.
    Makdisi G, Makdisi PB, Wang IW. Use of extracorporeal membranous oxygenator in transcatheter aortic valve replacement. Ann Transl Med. 2016;4(16):306.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    D'Ancona G, Pasic M, Buz S, Drews T, Dreysse S, Kukucka M, Hetzer R, Unbehaun A. Transapical transcatheter aortic valve replacement in patients with cardiogenic shock. Interact Cardiovasc Thorac Surg. 2012;14(4):426–30.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Roselli EE, Idrees J, Mick S, Kapadia S, Tuzcu M, Svensson LG, Lytle BW. Emergency use of cardiopulmonary bypass in complicated transcatheter aortic valve replacement: importance of a heart team approach. J Thorac Cardiovasc Surg. 2014;148(4):1413–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Hernandez-Vaquero D, Pascual I, Diaz R, Álvarez-Cabo R, Moris C, Silva J. How to perform a late surgical Explantation of a CoreValve aortic Bioprothesis. Ann Thorac Surg. 2017;103(6):e565–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Bruschi G, Oreglia J, De Marco F, Colombo P, Mondino M, Paino R, Klugmann S, Martinelli L. How to remove the CoreValve aortic bioprosthesis in a case of surgical aortic valve replacement. Ann Thorac Surg. 2012;93(1):329–30.CrossRefPubMedGoogle Scholar
  14. 14.
    Wang LW, Granger EK, McCourt JA, Pye R, Kaplan JM, Muller DW. Late surgical explantation and aortic valve replacement after transcatheter aortic valve implantation. Ann Thorac Surg. 2015;99(4):1434–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • A. Claire Watkins
    • 1
  • Anuj Gupta
    • 2
  • Bartley P. Griffith
    • 3
  1. 1.Department of Cardiothoracic SurgeryStanford University School of MedicineStanfordUSA
  2. 2.Division of CardiologyUniversity of Maryland, School of MedicineBaltimoreUSA
  3. 3.Division of Cardiac SurgeryUniversity of Maryland, School of MedicineBaltimoreUSA

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