Introduction: With the expansion of the indication for transcatheter aortic valve implantation (TAVR), the value of access to on-site emergency heart surgery at performing centers needs to be assessed.
Aims: To evaluate postoperative mortality after surgical rescue post-TAVR, in a population at high surgical risk.
Methods: Retrospective analysis of a cohort of patients included in the France-TAVI registry who had undergone TAVR with the latest generation valves between January 2017 and February 2020.
Results: Among the 968 patients undergoing TAVR, 6 patients (0.62%) were identified as candidates for surgery: 3 in the peri-operative context and 3 during hospitalization. Four subjects were managed in a salvage situation, two due to tamponade, one due to aortic dissection, and one due to aortic annulus rupture. One patient died of a delayed aortic annulus rupture and one patient presented a right coronary occlusion which was medically treated. All patients who underwent emergency surgery were discharged alive from the hospital.
Conclusions: In TAVR patients initially contraindicated for surgery, emergency bailout surgery could be performed successfully with all patients discharged alive. Access to on-site heart surgery represents a life-saving resource for TAVR centers.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/jocs.16954 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Recurrent Cardiac Tamponade Following Rotablator-Associated Coronary Perforation Treated with Additional Covered Stent Implantation.
Int Heart J
January 2025
Department of Cardiovascular Medicine, The Cardiovascular Institute.
Rotablator-associated coronary perforation can be fatal if bailout is delayed. Successful bailout is typically defined as the disappearance of contrast extravasation after a haemostatic intervention. We report a case of recurrent cardiac tamponade in the subacute phase, wherein haemostasis appeared to have been achieved on angiography following the implantation of a covered stent during the index procedure.
View Article and Find Full Text PDFSurgical Bailout in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement: Incidence, Trends, and Clinical Outcomes.
JACC Cardiovasc Interv
January 2025
Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. Electronic address:
Background: Transcatheter aortic valve replacement (TAVR) harbors the risk of periprocedural complications that require emergent cardiac surgery, or "surgical bailout." Surgical bailout intends to be lifesaving but is associated with high mortality. This has given rise to discussion on the necessity of surgical backup during TAVR.
View Article and Find Full Text PDFTranscatheter Bailout: An Important Option During Complex Aortic Surgery.
Ann Thorac Surg Short Rep
December 2024
Division of Adult Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California.
This report presents the case of a 66-year-old man with acute torrential aortic insufficiency after a Ross procedure 20 years earlier, a biologic aortic valve replacement 16 years earlier, and a transcatheter valve-in-valve 4 years earlier. He underwent third-time sternotomy, revealing that the pulmonary autograft was heavily calcified and frozen to the homograft. The previous transcatheter valve-in-valve was explanted.
View Article and Find Full Text PDFPost-closure Technique for Access Hemostasis During Emergency Endovascular Repair in Ruptured Abdominal Aortic Aneurysms: Technical Note on a Preliminary Experience.
Cardiovasc Intervent Radiol
January 2025
Department of Vascular and Endovascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, 242 Guangji Road, Gusu District, Suzhou, 215000, China.
Purpose: To describe the downsizing post-closure technique for access hemostasis during emergency endovascular repair (EVAR) in ruptured abdominal aortic aneurysms (RAAA).
Materials And Methods: A cohort of eight patients underwent emergency EVAR through 16 femoral access sites for infrarenal RAAA. The downsizing post-closure technique, which involves a reduction in the size of the large-bore access by advancing a 10F sheath, was consistently applied.
Successful Bailout of Catheter-Induced Dissection in Acute Myocardial Infarction Resulting From a Nondominant Right Coronary Artery Occlusion.
Case Rep Cardiol
December 2024
Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
A 48-year-old male with a history of hyperlipidemia presented to the emergency department with chest pain. Electrocardiographic abnormalities indicated an acute coronary syndrome. Urgent coronary angiography revealed nondominant right coronary artery (RCA) occlusion.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!