Short-term results of emergency conversion to surgery during transcatheter aortic valve replacement: A retrospective cohort study
10.7507/1007-4848.202306033
- VernacularTitle:经导管主动脉瓣置换术紧急中转外科手术近期结果的回顾性队列研究
- Author:
Qilin LU
1
;
Jieqiong ZHANG
2
;
Jinghui AN
2
;
Su LIU
2
;
Qianli MA
2
;
Fengwu SHI
2
Author Information
1. Graduate School, Hebei Medical University, Shijiazhuang, 050011, P. R. China
2. Department of Cardiovascular Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050004, P. R. China
- Publication Type:Journal Article
- Keywords:
Transcatheter aortic valve replacement;
surgery;
complications
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(08):1146-1150
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the short-term clinical outcomes of emergency conversion to surgery during transcatheter aortic valve replacement (TAVR). Methods Clinical data of patients who underwent emergency surgical conversion from TAVR in the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University, from 2018 to 2023 were collected. Postoperative follow-up results at 1 month were recorded. Results A total of 253 patients underwent TAVR, of whom 11 (4.3%) required emergency conversion to surgery. Among these 11 patients, 7 were male and 4 were female, with a mean age of (69.55±5.01) years. The primary cause for emergency surgical conversion was valve stent displacement (63.6%), followed by left ventricular perforation/rupture (18.2%) and significant perivalvular regurgitation persisting after a second valve implantation (18.2%). One (9.1%) patient died intraoperatively. Among the 10 surviving patients, postoperative complications included pulmonary infection in 8 patients, severe pneumonia in 7, pleural effusion in 3, liver dysfunction in 8, renal dysfunction in 3, upper gastrointestinal bleeding in 5, cerebrovascular complications in 1, atrial fibrillation in 1, ventricular premature contractions in 1, atrioventricular block in 1, and complete left bundle branch block in 3. At 1-month postoperative follow-up, one additional patient died, yielding a 30-day mortality rate of 18.2% after TAVR emergency surgical conversion. The quality of life improved significantly compared to preoperative status in 9 (81.8%) patients, and no patients were readmitted for cardiovascular diseases. Conclusion The incidence of emergency conversion to surgery during TAVR is low, but the rates of surgical complications and 30-day postoperative mortality are high. Nevertheless, when severe complications occur during TAVR, emergency conversion to surgery can still yield satisfactory short-term clinical outcomes for a majority of these patients.
