Complications of transcatheter aortic valve replacement and rescue attempts

As a novel treatment modality, transcatheter aortic valve replacement (TAVR) is widely used for patients with severe aortic valve stenosis who have high surgical risk worldwide. However, this promising alternative procedure has different types of complication risks including, cerebrovascular events, vascular complications, bleeding, coronary obstruction, myocardial infarction, valve regurgitation, valve malpositioning or migration, conduction disturbances and acute kidney injury which may occur during and/or after the procedure. These complications may be seen up to one third of the patients and some of them may need urgent surgical intervention and may have a higher risk of death. For preventing and overcoming these complications, pre-procedural evaluation of the patient by an effective “heart team” which consists of cardiologists, cardiac surgeons, radiologists and anesthesiologists in equal proportion is needed. Estimating the potential difficulties and complications, deciding the interventions to be performed in case of any complication may increase the success of the procedure and save the patients’ lives. In this article, we reviewed the possible complications of the TAVR procedure and described rescue procedures in case of complications, in the context of the literature

Axillary Artery Transection After Shoulder Dislocation

Axillary artery transection after shoulder dislocation without bone fracture is extremely rare. Early diagnosis, use of the occlusion balloon for proximal control of axillary artery bleeding, and surgical treatment are important to avoid morbidity and mortality. A 74-year old man presented with a complete transection of axillary artery associated with anterior dislocation of the shoulder without bone fracture. Left axillary artery transection was seen on angiography. An angioplasty balloon was used to prevent bleeding from the subclavian artery. The brachial plexus was compressed by a hematoma. Axillary artery repair was performed with an autologous reversed saphenous vein graft interposition. The patient had palpable distal pulses post-operatively. Motor function was significantly improved but still impaired in the postoperative period. Follow-up at 3 months showed good function of the left arm. Successful management of axillary artery injuries requires prompt diagnosis and surgical treatment. Neurologic injury may affect the functional outcome of the limb

Port catheter implantation under scopy in hybrid operation rooms

Background: This study aims to evaluate the results of port catheter implantation in hybrid operating rooms which have become widely used in cardiovascular surgery units in recent years, resulting new improvements

Anatomical and functional changes after aortic valve replacement with different sizes of mechanical valves

Bozok, Sahin/0000-0002-1256-5055WOS: 000457731600002PubMed: 30059131Objective: To date. there is no consensus on the selection of type and size of prosthetic valve for aortic valve replacement (AVR). the aim of this study was to compare anatomical and functional changes occurring in the left ventricle after AVR with different sizes of mechanical valves. Methods: A total of 92 patients with serious aortic valve stenosis. who underwent AVR between March 2001 and June 2008 using mechanical valves of different sizes. were retrospectively analysed. the sizes of mechanical valves v ere 19, 21, 23 and 25 mm. All patients were assessed pre-operatively and at six months and in first, third and fifth years postoperatively. the left ventricle was assessed with electrocardiography, echocardiography and telecardiography and compared in the four patient groups, constituted according to the mechanical valve size used. Results: in all groups, left ventricular mass and mass index. transvalvular aortic gradient. thicknesses of the interventricular septum and posterior wall and left ventricular end-systolic and end-diastolic diameters had decreased significantly post surgery. Left ventricular ejection fraction and exercise capacity had increased significantly (p < 0.001). the most noteworthy anatomical and functional improvements were seen in patients who had received 23- and 25-mm mechanical valves. Conclusion: Mechanical valve e replacement should not be performed with small size Ayes because of the higher residual gradient