title: Optimizing clinical outcomes of transcatheter aortic valve implantation patients with comorbidities.
abstract: Transcatheter aortic valve implantation (TAVI) has revolutionized the management of high-risk or inoperable patients presenting with symptomatic severe aortic stenosis (AS). There are several factors to consider to optimize patient outcomes from TAVI. Before TAVI, patient selection is key and an understanding the effects of common comorbidities on outcomes after TAVI is critical. Some comorbidities share common risk factors with AS (e.g. coronary artery disease), others are directly or indirectly caused or exacerbated by severe AS (e.g. atrial fibrillation, pulmonary hypertension, mitral regurgitation, tricuspid regurgitation and right ventricular dysfunction), whereas others are not directly related to severe AS (e.g. chronic kidney disease and chronic lung disease). Choice of transcatheter heart valve prosthesis, vascular access route and mode of anesthesia are important considerations during TAVI. New onset conduction disturbances and arrhythmias remain a vexing issue after TAVI. The aim of the present review is to provide an overview of these issues.
authors.affiliation: a Department of Cardiology , Stadtspital Triemli , Zürich , Switzerland.
authors.forename: Crochan J
authors.initials: CJ
authors.lastname: O'Sullivan
authors.affiliation: b Department of Cardiology , Bern University Hospital , Bern , Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Wenaweser
mesh_terms: D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology*; D006801:Humans; D018579:Patient Selection; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D012307:Risk Factors; D012720:Severity of Illness Index; D061665:Time-to-Treatment; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
keywords: aortic stenosis; atrial fibrillation; conduction abnormalities; mitral regurgitation; pulmonary hypertension; transcatheter aortic valve implantation; transcatheter heart valve