A Practical Guide to Prevention and Treatment of Complications during Transcatheter Aortic Valve Implantation   

Calcific aortic stenosis (AS) is the most common heart valve anomaly, with a largely age-dependent prevalence, a calculated annual incidence rate in the range of 4-5% in general populations and up to 6% in patients aged 75 years and over.  

Surgical aortic valve replacement (SAVR) was previously the only option available to patients with symptomatic, severe aortic stenosis. After the first-in-human transcatheter aortic valve implantation (TAVI) was performed by Alain Cribier in 2002, the treatment strategy for patients with symptomatic AS has been revolutionized. Since then, TAVI has grown exponentially, as a result of accruing evidence demonstrating safety and efficacy, and reduced invasiveness compared with SAVR.  TAVI devices are continuously expanding to include several valve design options. As this strategy is continuously evolving to treat younger patients and lower-risk populations, aside from the long-term durability of the valve systems, procedural safety will become the focus of newer-generation devices. 

This book is a practical handbook devoted to the optimization of TAVI procedures, through a focused containment of complications. Through an integrated evaluation of the clinical status, imaging techniques and laboratory findings, the authors provide readers with clear messages on preventive and therapeutic recommendations. 

About the Editors

Marco Zimarino, Institute of Cardiology “G. d’Annunzio” University, Interventional Cath Lab, ASL 2 Abruzzo, Chieti, Italy

Ron Waksman, MedStar Heart & Vascular Institute, Medstar Washington Hospital Center, Washington, DC, USA

Ignacio J. Amat-Santos, Department of Cardiology, Instituto de Ciencias del Corazón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Hospital Clínico Universitario de Valladolid, Spain

Corrado Tamburino, Azienda Ospedaliero-Universitaria Policlinico “G. Rodolico- San Marco”, University of Catania, Catania, Italy

1. Introduction
Marco Zimarino and Corrado Tamburino

PART I: General complications <do you want the book to be divided into two parts – or is the distinction on the supplied ToC for reference only?>

2. Vascular complications
Sebastiano Immè and Claudia I. Tamburino

3. Annular rupture
Claudia Reddavid, Carmelo Sgroi, Corrado Tamburino and Marco Barbanti

4. Coronary obstruction
Henrique B. Ribeiro, Antonio Fernando D. Freire, Josep Rodés-Cabau

5. Cerebrovascular events
Luca Testa, Gaetano Pero, Antonio Popolo Rubbio, Matteo Casenghi, Magdalena Cuman, Francesco Bedogni

6. Ventricular perforation
Mei Chau1, Alfonso Ielasi2, Azeem Latib3

7. Valve migration
Heath SL Adams, Tiffany Patterson, Simon Redwood, Bernard Prendergast

8. Paravalvular leaks
Joris Ooms, Zouhair Rahhab, Nicolas M. Van Mieghem

9. Conduction disturbances
Itsik Ben-Dor, Ron Waksman

10. Leaflet thrombosis
Sam Dawkins, Tarun Chakravarty, Raj Makkar

11. Bleeding
Francesco Radico, Raffaele Piccolo, Umberto Ianni, Sabina Gallina, and Marco Zimarino

12. Renal dysfunction
Francesco Saia, Gabriele Ghetti, Nevio Taglieri

PART II: Specific complications

13. Bicuspid valve
Anna Franzone, Eugenio Stabile, Plinio Cirillo, Giovanni Esposito

14. Degenerated aortic bioprosthesis
Tania Rodríguez-Gabella, Carlos Cortés, Alberto San Román, Ignacio J. Amat-Santos

15. Low-flow low-gradient aortic stenosis
Francesco Cardaioli, Chiara Fraccaro, Tommaso Fabris, Giuseppe Tarantini

16. Concomitant mitral regurgitation
Felice Gragnano, Carmen Spaccarotella, Andreina Carbone, Augusto Esposito, Paolo Calabrò, Giampaolo Niccoli

17. Alternative transcatheter approaches
Marco De Carlo, Cristina Giannini, Anna Sonia Petronio,

18. Transapical and direct aortic approach
Filippo Capestro, Paolo Berretta, Utz Kappert, Marco Di Eusanio

19. Patients needing hemodynamic support
Jacopo Andrea Oreglia, Federico De Marco, Francesco Soriano, Stefano Nava

20. Coronary angiography and interventions after TAVI
Stefano Cannata, Matteo Perfetti, Tanya Salvatore, Caterina Gandolfo, Nicola Maddestra

21. Complex femoral accesses
Damiano Regazzoli, Jorge Sanz-Sáncheza, Giulio Giuseppe Stefanini, Bernhard Reimers

22. Low-risk patients
Brian C. Case, Toby Rogers, Ron Waksman

23. Gender peculiarities
Ridhima Goel, Davide Cao, Roxana Mehran

24. The pathologist perspective
Sho Torii, Yu Sato, Dipti Surve, Maria E. Romero, Aloke V Finn and Renu Virmani

25. Conclusion: what we learnt from clinical trials and real-world experience
Paolo D’Arrigo, Piera Capranzano, Davide Capodanno