Incidence and Management of CoreValve Dislocation During Transcatheter Aortic Valve Implantation
- 1 December 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Cardiovascular Interventions
- Vol. 3 (6), 531-536
- https://doi.org/10.1161/circinterventions.110.944983
Abstract
Transcatheter aortic valve implantation is a highly specialized technique offering a new therapeutic option to patients at high risk for conventional surgery. Complications associated with this catheter procedure differ from complications after surgical aortic valve replacement. This is to report incidence, management, and impact on morbidity and mortality of CoreValve dislocation during catheter valve implantation. Between June 2007 and September 2009, the self-expandable CoreValve prosthesis (Medtronic Inc, Minneapolis, Minn) was implanted in 212 patients through a transarterial (femoral or subclavian) access. Patients with severe aortic stenosis who were at high risk for conventional surgery were included. We observed dislocation of the prosthesis during CoreValve implantation in 21 patients. In 16 cases, the CoreValve could be implanted in the correct annular position after retrieving it and reloading the catheter. In 4 patients, the completely deployed prosthesis had to be placed in the ascending or abdominal aorta before implanting a second one. One patient underwent open surgery. Overall 30-day mortality was 11.0%, 21.5% in the dislocation group and 9.9% in patients without dislocation ( P =0.024). Coronary ischemia, stroke, and renal failure occurred more frequently in patients with dislocation, whereas pacemaker dependency did not differ significantly between the groups. CoreValve dislocation during transcatheter aortic valve implantation occurred in 10% of the cases and significantly increases perioperative risk for severe complications or death. It requires individual specific management and can be managed either interventionally or, rarely, results in open surgery.Keywords
This publication has 22 references indexed in Scilit:
- Survival after transapical and transfemoral aortic valve implantation: Talking about two different patient populationsThe Journal of Thoracic and Cardiovascular Surgery, 2009
- Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team☆European Journal of Cardio-Thoracic Surgery, 2009
- Progress and Current Status of Percutaneous Aortic Valve Replacement: Results of Three Device Generations of the CoreValve Revalving SystemCirculation: Cardiovascular Interventions, 2008
- First Successful Aortic Valve Implantation with the CoreValve ReValving™ System via Right Subclavian Artery Access: A Case ReportThe Heart Surgery Forum, 2008
- United States Feasibility Study of Transcatheter Insertion of a Stented Aortic Valve by the Left Ventricular ApexThe Annals of Thoracic Surgery, 2008
- Guidelines for reporting mortality and morbidity after cardiac valve interventions☆European Journal of Cardio-Thoracic Surgery, 2008
- Outcomes of elderly patients aged 80 and over with symptomatic, severe aortic stenosis: impact of patient's choice of refusing aortic valve replacement on survivalQJM: An International Journal of Medicine, 2008
- Unoperated Patients With Severe Aortic StenosisJournal of the American College of Cardiology, 2007
- Percutaneous Aortic Valve Replacement for Severe Aortic Stenosis in High-Risk Patients Using the Second- and Current Third-Generation Self-Expanding CoreValve ProsthesisJournal of the American College of Cardiology, 2007
- Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic StenosisCirculation, 2002