__Abstract__



Transcatheter Aortic Valve Implantation (TAVI) has emerged as a viable and safe

treatment for patients with severe aortic stenosis (AS) who are considered ineligible or at

prohibitive risk for Surgical Aortic Valve Replacement (SAVR)1–4. The aim of the present

thesis was to evaluate the in-hospital complications and the determinants or factors

associated with outcome after TAVI, thereby, offering insight into the pathophysiology

of complications that in turn may help to propose recommendations to improve the

planning, execution and follow-up of TAVI

Boon, R.M.A. (Robert) van der

Erasmus University Digital Repository

STELLINGENbehorende bij het proefschrift:Transcatheter Aortic Valve Implantation: Insights into Clinical Complications1.  The risk of complications after TAVI is multifactorial, which can be defi ned as patient-related, procedure- or operator-related and device-related (this thesis).2.  Outcome after TAVI can be improved by appropriate patient selection taking into account variables not included in traditional risk algorithms and treatment allocation based on the consensus of a multidisciplinary heart team (this thesis).3.  Knowledge of the intimate relationship and proximity of the atrioventricular conduction axis with the aortic root allows us to understand the pathological mechanisms underlying new conduction abnormalities after TAVI (this thesis).4.  Appreciation of factors related specifi cally to the devices, procedure and patients makes it possible to predict the occurrence of new conduction abnormalities, and might change the procedure and devices (this thesis).5.  The exponential use of TAVI will further increase due to further innovations in technology, further increase in experience, better insights into the determinants or pathophysiology of complications, innovations in software guiding the physician to obtain more accurate sizing and positioning and, last but not least, awareness and demand from society for less invasive procedures (this thesis).6.  Despite all clinical scientifi c innovations including complex treatment decision-making software and (sophisticated) risk models, clinical medicine remains an art that is to be performed by adequately trained physicians who are experts by actively performing procedures in suffi cient numbers and working in the right environment (this thesis).7.  Cardiologists, cardiac surgeons, anaesthesiologists, imaging specialists, geriatricians, nurses and technicians have learned to work together towards a unique goal: making TAVI possible, safe and successful with optimal patient outcome (Prof. Alain Cribier, MD,PhD; Arch Cardiovasc Dis. 2012 Mar;105(3):146-52).8. The great tragedy of science - the slaying of a beautiful hypothesis by an ugly fact (Thomas Huxley).9.  An error does not become truth by reason of multiplied propagation, nor does truth become error because nobody sees it (Mahatma Gandhi).10.  Continuous effort - not strength or intelligence - is the key to unlocking our potential (Winston Churchill).11.  Anyone who conducts an argument by appealing to authority is not using his intelligence; he is just using his memory (Leonardo da Vinci).Robert M.A. van der Boon, 14 mei 2014

Transcatheter Aortic Valve Implantation: Insights into Clinical Complications

van der Boon, Robert

EUR Research Repository

English