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Emergent Conversion to Open Heart Surgery during Transcatheter Aortic Valve Implantation: The Presence of a Rescue Team Improves Outcomes.
Nasso, Giuseppe; Vignaroli, Walter; Contegiacomo, Gaetano; Marchese, Alfredo; Fattouch, Khalil; D'Alessandro, Pasquale; Brigiani, Mario Siro; Vitobello, Vincenza; Triggiani, Vera; Demola, Maria Antonietta; Tonioni, Stefano; Paparella, Domenico; Sechi, Stefano; Bonifazi, Raffaele; Santarpino, Giuseppe; Resta, Fabrizio; Bartolomucci, Francesco; Lorusso, Roberto; Larosa, Claudio; Valenti, Giovanni; Tito, Antonio; Moscarelli, Marco; Margari, Vito; Fiore, Flavio; Condello, Ignazio; Speziale, Giuseppe.
Afiliación
  • Nasso G; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Vignaroli W; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Contegiacomo G; Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy.
  • Marchese A; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Fattouch K; Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy.
  • D'Alessandro P; Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy.
  • Brigiani MS; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Vitobello V; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Triggiani V; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Demola MA; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Tonioni S; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Paparella D; Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy.
  • Sechi S; Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Bonifazi R; Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy.
  • Santarpino G; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Resta F; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Bartolomucci F; Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Lorusso R; Department of Cardiology, Hospital of Andria, 76123 Andria, Italy.
  • Larosa C; Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), 6229 HX Maastricht, The Netherlands.
  • Valenti G; Department of Cardiology, Hospital of Andria, 76123 Andria, Italy.
  • Tito A; Department of Cardiology, Hospital of Andria, 76123 Andria, Italy.
  • Moscarelli M; Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Margari V; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Fiore F; Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Condello I; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
  • Speziale G; Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy.
J Clin Med ; 12(24)2023 Dec 15.
Article en En | MEDLINE | ID: mdl-38137774
ABSTRACT

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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza