Review of Reported Causes of Device Embolization Following Trans-Catheter Aortic Valve Implantation

Uzoma N. Ibebuogu, Smith Giri, Oluwaseyi Bolorunduro, Paolo Tartara, Saibal Kar, David Holmes, Oluseun Alli

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Transcatheter heart valve (THV) embolization is a rare but serious complication of transcatheter aortic valve implantation. Studies, including case reports, case series, and original reports published between 2002 and 2013, with regard to THV embolization were identified with a systemic electronic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A total of 19 publications describing 71 patients were identified. Most patients (64%) were men, with a mean age of 80 ± 6 years and a mean logistic European System for Cardiac Operative Risk Evaluation score of 22.4 ± 9.3%. Balloon-expandable valves were used in 72% of the patients. The reported transcatheter aortic valve replacement access site was transfemoral in 80% of patients. Most cases (90%) occurred <1 hour after implantation, whereas 10% had late embolization (range 4 hours to 43 days). The most common site of embolization was the ascending aorta (38%), followed by the left ventricle (31%), descending aorta (23%), and aortic arch (8%). Open-heart surgery was required in 28% for valve retrieval and replacement. The 30-day stroke and mortality rates were 11% and 17%, respectively. Ventricular embolization and urgent conversion to open-heart surgery were significantly associated with death during hospitalization (p = 0.017 and p = 0.029, respectively). Likely causes of embolization were identified in 59 patients, with positioning error as the most commonly reported (47%), followed by pacing error (13%). In conclusion, THV embolization occurred early after transcatheter aortic valve implantation. The ascending aorta was the most common site of embolization. Higher 30-day stroke and mortality rates were associated with THV embolization compared with most published series of transcatheter aortic valve implantation outcomes.

Original languageEnglish (US)
Article number21062
Pages (from-to)1767-1772
Number of pages6
JournalAmerican Journal of Cardiology
Volume115
Issue number12
DOIs
StatePublished - Jun 15 2015

Fingerprint

Heart Valves
Aortic Valve
Catheters
Equipment and Supplies
Thoracic Aorta
Thoracic Surgery
Aorta
Stroke
Conversion to Open Surgery
Patient Positioning
Mortality
Heart Ventricles
Publications
Meta-Analysis
Hospitalization
Transcatheter Aortic Valve Replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Review of Reported Causes of Device Embolization Following Trans-Catheter Aortic Valve Implantation. / Ibebuogu, Uzoma N.; Giri, Smith; Bolorunduro, Oluwaseyi; Tartara, Paolo; Kar, Saibal; Holmes, David; Alli, Oluseun.

In: American Journal of Cardiology, Vol. 115, No. 12, 21062, 15.06.2015, p. 1767-1772.

Research output: Contribution to journalReview article

Ibebuogu, Uzoma N. ; Giri, Smith ; Bolorunduro, Oluwaseyi ; Tartara, Paolo ; Kar, Saibal ; Holmes, David ; Alli, Oluseun. / Review of Reported Causes of Device Embolization Following Trans-Catheter Aortic Valve Implantation. In: American Journal of Cardiology. 2015 ; Vol. 115, No. 12. pp. 1767-1772.
@article{1313017bda1c4a2e8042065fe11b6d6f,
title = "Review of Reported Causes of Device Embolization Following Trans-Catheter Aortic Valve Implantation",
abstract = "Transcatheter heart valve (THV) embolization is a rare but serious complication of transcatheter aortic valve implantation. Studies, including case reports, case series, and original reports published between 2002 and 2013, with regard to THV embolization were identified with a systemic electronic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A total of 19 publications describing 71 patients were identified. Most patients (64{\%}) were men, with a mean age of 80 ± 6 years and a mean logistic European System for Cardiac Operative Risk Evaluation score of 22.4 ± 9.3{\%}. Balloon-expandable valves were used in 72{\%} of the patients. The reported transcatheter aortic valve replacement access site was transfemoral in 80{\%} of patients. Most cases (90{\%}) occurred <1 hour after implantation, whereas 10{\%} had late embolization (range 4 hours to 43 days). The most common site of embolization was the ascending aorta (38{\%}), followed by the left ventricle (31{\%}), descending aorta (23{\%}), and aortic arch (8{\%}). Open-heart surgery was required in 28{\%} for valve retrieval and replacement. The 30-day stroke and mortality rates were 11{\%} and 17{\%}, respectively. Ventricular embolization and urgent conversion to open-heart surgery were significantly associated with death during hospitalization (p = 0.017 and p = 0.029, respectively). Likely causes of embolization were identified in 59 patients, with positioning error as the most commonly reported (47{\%}), followed by pacing error (13{\%}). In conclusion, THV embolization occurred early after transcatheter aortic valve implantation. The ascending aorta was the most common site of embolization. Higher 30-day stroke and mortality rates were associated with THV embolization compared with most published series of transcatheter aortic valve implantation outcomes.",
author = "Ibebuogu, {Uzoma N.} and Smith Giri and Oluwaseyi Bolorunduro and Paolo Tartara and Saibal Kar and David Holmes and Oluseun Alli",
year = "2015",
month = "6",
day = "15",
doi = "10.1016/j.amjcard.2015.03.024",
language = "English (US)",
volume = "115",
pages = "1767--1772",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "12",

}

TY - JOUR

T1 - Review of Reported Causes of Device Embolization Following Trans-Catheter Aortic Valve Implantation

AU - Ibebuogu, Uzoma N.

AU - Giri, Smith

AU - Bolorunduro, Oluwaseyi

AU - Tartara, Paolo

AU - Kar, Saibal

AU - Holmes, David

AU - Alli, Oluseun

PY - 2015/6/15

Y1 - 2015/6/15

N2 - Transcatheter heart valve (THV) embolization is a rare but serious complication of transcatheter aortic valve implantation. Studies, including case reports, case series, and original reports published between 2002 and 2013, with regard to THV embolization were identified with a systemic electronic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A total of 19 publications describing 71 patients were identified. Most patients (64%) were men, with a mean age of 80 ± 6 years and a mean logistic European System for Cardiac Operative Risk Evaluation score of 22.4 ± 9.3%. Balloon-expandable valves were used in 72% of the patients. The reported transcatheter aortic valve replacement access site was transfemoral in 80% of patients. Most cases (90%) occurred <1 hour after implantation, whereas 10% had late embolization (range 4 hours to 43 days). The most common site of embolization was the ascending aorta (38%), followed by the left ventricle (31%), descending aorta (23%), and aortic arch (8%). Open-heart surgery was required in 28% for valve retrieval and replacement. The 30-day stroke and mortality rates were 11% and 17%, respectively. Ventricular embolization and urgent conversion to open-heart surgery were significantly associated with death during hospitalization (p = 0.017 and p = 0.029, respectively). Likely causes of embolization were identified in 59 patients, with positioning error as the most commonly reported (47%), followed by pacing error (13%). In conclusion, THV embolization occurred early after transcatheter aortic valve implantation. The ascending aorta was the most common site of embolization. Higher 30-day stroke and mortality rates were associated with THV embolization compared with most published series of transcatheter aortic valve implantation outcomes.

AB - Transcatheter heart valve (THV) embolization is a rare but serious complication of transcatheter aortic valve implantation. Studies, including case reports, case series, and original reports published between 2002 and 2013, with regard to THV embolization were identified with a systemic electronic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A total of 19 publications describing 71 patients were identified. Most patients (64%) were men, with a mean age of 80 ± 6 years and a mean logistic European System for Cardiac Operative Risk Evaluation score of 22.4 ± 9.3%. Balloon-expandable valves were used in 72% of the patients. The reported transcatheter aortic valve replacement access site was transfemoral in 80% of patients. Most cases (90%) occurred <1 hour after implantation, whereas 10% had late embolization (range 4 hours to 43 days). The most common site of embolization was the ascending aorta (38%), followed by the left ventricle (31%), descending aorta (23%), and aortic arch (8%). Open-heart surgery was required in 28% for valve retrieval and replacement. The 30-day stroke and mortality rates were 11% and 17%, respectively. Ventricular embolization and urgent conversion to open-heart surgery were significantly associated with death during hospitalization (p = 0.017 and p = 0.029, respectively). Likely causes of embolization were identified in 59 patients, with positioning error as the most commonly reported (47%), followed by pacing error (13%). In conclusion, THV embolization occurred early after transcatheter aortic valve implantation. The ascending aorta was the most common site of embolization. Higher 30-day stroke and mortality rates were associated with THV embolization compared with most published series of transcatheter aortic valve implantation outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84930182870&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930182870&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2015.03.024

DO - 10.1016/j.amjcard.2015.03.024

M3 - Review article

C2 - 25882773

AN - SCOPUS:84930182870

VL - 115

SP - 1767

EP - 1772

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 12

M1 - 21062

ER -