title: Injuries to the Aorta, Aortic Annulus, and Left Ventricle During Transcatheter Aortic Valve Replacement: Management and Outcomes.
abstract: The experience with transcatheter aortic valve replacement is increasing worldwide; however, the incidence of potentially catastrophic cardiac or aortic complications has not decreased. In most cases, significant injuries to the aorta, aortic valve annulus, and left ventricle require open surgical repair. However, the transcatheter aortic valve replacement patient presents a unique challenge as many patients are at high or prohibitive surgical risk and, therefore, an open surgical procedure may not be feasible or appropriate. Consequently, prevention of these potentially catastrophic injuries is vital, and practitioners need to understand when open surgical repair is required and when alternative management strategies can be used. The goal of this article is to provide an overview of current management and prevention strategies for major complications involving the aorta, aortic valve annulus, and left ventricle.
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Nathaniel B
authors.initials: NB
authors.lastname: Langer
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Nadira B
authors.initials: NB
authors.lastname: Hamid
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Tamim M
authors.initials: TM
authors.lastname: Nazif
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Omar K
authors.initials: OK
authors.lastname: Khalique
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Torsten P
authors.initials: TP
authors.lastname: Vahl
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Jonathon
authors.initials: J
authors.lastname: White
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Juan
authors.initials: J
authors.lastname: Terre
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Ramin
authors.initials: R
authors.lastname: Hastings
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Diana
authors.initials: D
authors.lastname: Leung
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Hahn
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Martin
authors.initials: M
authors.lastname: Leon
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Susheel
authors.initials: S
authors.lastname: Kodali
authors.affiliation: From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY. ig2006@cumc.columbia.edu.
authors.forename: Isaac
authors.initials: I
authors.lastname: George
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*
keywords: aortic valve stenosis; cardiovascular surgical procedures; intraoperative complications; transcatheter aortic valve replacement