Transcatheter aortic valve replacement causing acute cardiac tamponade:clinical analysis of 5 cases
10.3969/j.issn.1008-794X.2025.11.012
- VernacularTitle:5例经导管主动脉瓣置换术并发急性心脏压塞患者的临床分析
- Author:
Congle YIN
1
;
Yuchen WEN
;
Qing YE
;
Jianwei ZHOU
;
Zhen FANG
;
Daoqian CHEN
;
Jun JI
;
Bing XU
;
Shenghu HE
Author Information
1. 225009 江苏扬州 扬州大学附属苏北人民医院;苏北人民医院心血管内科
- Keywords:
transcatheter aortic valve replacement;
acute cardiac tamponade;
perforation of cardiac structure;
pericardiocentesis;
thoracotomy
- From:
Journal of Interventional Radiology
2025;34(11):1228-1234
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the causes and the therapeutic strategy of acute cardiac tamponade(ACT)occurring as a complication of transcatheter aortic valve replacement(TAVR)so as to improve the success rate of the surgery and to make a further understanding of this complication.Methods The general clinical data,surgical procedures,and postoperative follow-up results of five patients,who received TAVR at the Affiliated Northern Jiangsu People's Hospital of Yangzhou University of China and developed ACT from March 2018 to September 2024,were retrospectively analyzed.Results After developing ACT,all the 5 patients received pericardiocentesis together with other adjuvant therapies including blood volume expansion with infusion,vasopressors,heparin neutralization,and blood transfusion.However,due to no obvious reduction in drainage volume and unstable hemodynamics all the 5 patients had eventually to receive open-chest surgery to identify the source of bleeding and to make hemostasis.Surgical exploration revealed that the perforation or rupture of cardiac structures caused by the temporary pacemaker lead or a super-stiff guide wire during the procedure was the main cause of ACT.Finally,after active treatment four patients recovered and discharged,and one patient died.The discharged patients were followed up for 3-12 months,and no procedure-related complications such as acute coronary artery occlusion,severe arrhythmia,exacerbation of heart failure symptoms,valve displacement,or stroke occurred.Conclusion As a severe complication occurring during the TAVR procedure,ACT requires to get a rapid diagnosis and management.Improvement of surgical techniques and operative methods,comprehensive preoperative assessment,and close intraoperative monitoring are crucial points for the prevention of ACT.
