Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac Center
Background: Cardiac tamponade is a rare but potentially lethal complication of transcatheter aortic valve replacement (TAVR). There is paucity of evidence assessing the incidence and outcomes of patients with cardiac tamponade after TAVR. Methods: A retrospective review was performed of all patients...
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Elsevier
2025-02-01
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| Series: | Structural Heart |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2474870624001118 |
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| author | Simrat Kaur, MD Vinayak Nagaraja, MD Paul Schoenhagen, MD M. Marwan Dabbagh, MD Najdat Bazarbashi, MD Shameer Khubber, MD Manpreet Kaur, MD Gad Mohomad, MD Beni Verma, MD James Yun, MD Lars Svensson, MD, PhD Murat Tuzcu, MD Zoran B. Popović, MD, PhD Amar Krishnaswamy, MD Samir Kapadia, MD |
| author_facet | Simrat Kaur, MD Vinayak Nagaraja, MD Paul Schoenhagen, MD M. Marwan Dabbagh, MD Najdat Bazarbashi, MD Shameer Khubber, MD Manpreet Kaur, MD Gad Mohomad, MD Beni Verma, MD James Yun, MD Lars Svensson, MD, PhD Murat Tuzcu, MD Zoran B. Popović, MD, PhD Amar Krishnaswamy, MD Samir Kapadia, MD |
| author_sort | Simrat Kaur, MD |
| collection | DOAJ |
| description | Background: Cardiac tamponade is a rare but potentially lethal complication of transcatheter aortic valve replacement (TAVR). There is paucity of evidence assessing the incidence and outcomes of patients with cardiac tamponade after TAVR. Methods: A retrospective review was performed of all patients who underwent TAVR at our institution from January 2013 to January 2019. The clinical characteristics of patients who developed cardiac tamponade in the periprocedural period were compared to the patients who did not develop tamponade. Qualitative and quantitative assessment of aortic annular calcium distribution on cardiac computerized tomography was analyzed. Results: Twenty out of 2030 patients (0.9%) developed cardiac tamponade post-TAVR. The mean age of the cohort developing cardiac tamponade was 81.7 years, and 50% of them were men. Most of these were intraprocedural (70%) while the remaining were identified in the postprocedural period. The site of injury resulting in pericardial tamponade was thought to be from the injury to aortic annulus (50%), right ventricle (40%), and left ventricle (10%). Tamponade due to annular or left ventricular trauma was mostly identified intraprocedurally (91%; n = 10 of 11), while patients with tamponade due to presumed right ventricular injury were mostly identified in the postprocedural period (62.5%; n = 5 of 8) (p = 0.009). Conservative management with supportive therapies was employed in 90% of patients with cardiac tamponade, while two patients had cardiac surgery. There was one in-hospital mortality, and another patient died within 30 days of the TAVR procedure. Conclusion: The incidence of cardiac tamponade after TAVR (0.9%) was low, and this serious complication can be managed successfully in the majority of patients with streamlined processes in high-volume centers. |
| format | Article |
| id | doaj-art-14f95130a768444eaae1c2b6d009afb5 |
| institution | DOAJ |
| issn | 2474-8706 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Structural Heart |
| spelling | doaj-art-14f95130a768444eaae1c2b6d009afb52025-08-20T03:16:28ZengElsevierStructural Heart2474-87062025-02-019210035610.1016/j.shj.2024.100356Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac CenterSimrat Kaur, MD0Vinayak Nagaraja, MD1Paul Schoenhagen, MD2M. Marwan Dabbagh, MD3Najdat Bazarbashi, MD4Shameer Khubber, MD5Manpreet Kaur, MD6Gad Mohomad, MD7Beni Verma, MD8James Yun, MD9Lars Svensson, MD, PhD10Murat Tuzcu, MD11Zoran B. Popović, MD, PhD12Amar Krishnaswamy, MD13Samir Kapadia, MD14Department of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Interventional Cardiology, Section of Interventional Cardiology, Cardiovascular Medicine, Mayo Clinic, Rochester, MinnesotaDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Internal Medicine, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, OhioDepartment of Internal Medicine, University of Maryland Medical Center Baltimore, MarylandDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiovascular Surgery, Section of Cardiovascular Surgery, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiovascular Surgery, Section of Cardiovascular Surgery, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiology, Section of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio; Address correspondence to: Samir Kapadia MD, Chairman Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart & Vascular Institute, Cleveland Clinic, J2-39500 Euclid Ave Cleveland, OH 44195.Background: Cardiac tamponade is a rare but potentially lethal complication of transcatheter aortic valve replacement (TAVR). There is paucity of evidence assessing the incidence and outcomes of patients with cardiac tamponade after TAVR. Methods: A retrospective review was performed of all patients who underwent TAVR at our institution from January 2013 to January 2019. The clinical characteristics of patients who developed cardiac tamponade in the periprocedural period were compared to the patients who did not develop tamponade. Qualitative and quantitative assessment of aortic annular calcium distribution on cardiac computerized tomography was analyzed. Results: Twenty out of 2030 patients (0.9%) developed cardiac tamponade post-TAVR. The mean age of the cohort developing cardiac tamponade was 81.7 years, and 50% of them were men. Most of these were intraprocedural (70%) while the remaining were identified in the postprocedural period. The site of injury resulting in pericardial tamponade was thought to be from the injury to aortic annulus (50%), right ventricle (40%), and left ventricle (10%). Tamponade due to annular or left ventricular trauma was mostly identified intraprocedurally (91%; n = 10 of 11), while patients with tamponade due to presumed right ventricular injury were mostly identified in the postprocedural period (62.5%; n = 5 of 8) (p = 0.009). Conservative management with supportive therapies was employed in 90% of patients with cardiac tamponade, while two patients had cardiac surgery. There was one in-hospital mortality, and another patient died within 30 days of the TAVR procedure. Conclusion: The incidence of cardiac tamponade after TAVR (0.9%) was low, and this serious complication can be managed successfully in the majority of patients with streamlined processes in high-volume centers.http://www.sciencedirect.com/science/article/pii/S2474870624001118Cardiac tamponadeTertiary care centerTranscatheter aortic valve replacement |
| spellingShingle | Simrat Kaur, MD Vinayak Nagaraja, MD Paul Schoenhagen, MD M. Marwan Dabbagh, MD Najdat Bazarbashi, MD Shameer Khubber, MD Manpreet Kaur, MD Gad Mohomad, MD Beni Verma, MD James Yun, MD Lars Svensson, MD, PhD Murat Tuzcu, MD Zoran B. Popović, MD, PhD Amar Krishnaswamy, MD Samir Kapadia, MD Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac Center Structural Heart Cardiac tamponade Tertiary care center Transcatheter aortic valve replacement |
| title | Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac Center |
| title_full | Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac Center |
| title_fullStr | Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac Center |
| title_full_unstemmed | Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac Center |
| title_short | Outcomes of Cardiac Tamponade Post-Transcatheter Aortic Valve Replacement: Results From a Tertiary Cardiac Center |
| title_sort | outcomes of cardiac tamponade post transcatheter aortic valve replacement results from a tertiary cardiac center |
| topic | Cardiac tamponade Tertiary care center Transcatheter aortic valve replacement |
| url | http://www.sciencedirect.com/science/article/pii/S2474870624001118 |
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