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Risks and complications of transcatheter aortic implantations
Every surgical or invasive technique, as TAVI is, entails a series of potential risks or complications.
Why is this technique used if there are risks?
Despite carrying certain risks, choosing this technique in particular is because the risk associated to it is lower than other techniques and the main disease, as aortic stenosis is, whose evolution is very unfavorable without a proper treatment. However, even assuming that risks are lower than benefits, the proper and early handling of the complications that may occur is essential for its impact to be the least possible risk.
What complications can appear during or after this technique?
Every patient who is performed this of such a procedure will be informed with detail of the possible complications or adverse situations, through a document called “consent form”. Although still rare, it has to be taken into consideration that the following complications, among others, may occur:
Necessity of implanting a pacemaker
Anatomically, near the aortic valve, there is a conducting issue segment, so the same treatment of the aortic stenosis can result in an atrioventricular block that may require a pacemaker implantation.
Neurological complications
Atria where this type of prosthesis is introduced, as well as the aortic valve, can liberate some fragments of calcium in the bloodstream, whose effect would result in a neurological problem in the most unfavorable cases (in case of addressing to the nervous system).
Alterations in the implanted valve function
Sometimes, a complex anatomy or the aortic valve conditions may hinder the proper function of the TAVI implantation, so it can be necessary to relocate such prosthesis, or in less frequent cases, convert the procedure into a conventional valve replacement (open surgery with extracorporeal circulation).
Hemorrhage
Even less frequently, some of the arteries used, the aorta or even heart can present some types of bleeding. In extreme cases, a surgical intervention to treat this problem can be necessary.
Taking into consideration some of the problems described, it is necessary to highlight the necessity of performing these procedures at centres where the responsible teams are able to handle these situations, which reduces its impact.
In this line, the working group of the Spanish Society of Thoracic-Cardiovascular Surgery has completed a map of “Centres with surgical coverage”, experienced in TAVI.
