Non-access site complications in transcutaneous aortic valve replacement

Background: Transcatheter aortic valve replacement for severe aortic stenosis patients became an acceptable non inferior alternative to routine surgical replacement with good outcomes in high-risk patients and inoperable patients. But a new group of complications start to be encountered after performing this procedure, one of these groups is non-access site complication. Objectives: in this study we try to find the incidence of post transcutaneous aortic valve replacement complications, especially non-access site complications, and try to find if there are any association between some risk factors and complications incidence. Methods: From 2015 to 2022, a total of 89 patients can be followed in transcutaneous aortic valve replacement clinic at queen alia heart institute. baseline patient characteristics, procedural details, and clinical outcomes retrospectively collected through reviewing their electronic medical files. We evaluated the total cohort for different types of complications, especially the following: post procedural acute kidney injury, post procedural high degree atrioventricular block mandating permanent pacemaker implantation, post procedural cerebrovascular accident, post procedural paravalvular leak and intraprocedural acute pulmonary edema. We try to find a relationship between. These major complications and certain risk factors as diabetes, hypertension, pre-existing chronic kidney disease, associated mitral valve dysfunction, pre-existing conduction abnormalities and left ventricular dysfunction. Study population also divided into subgroups according to age and gender, and we try to find a difference between these subgroups regarding incidence of complication. Results: Mean patient age was 80 ± 7 years, 49.4% of the patients were women, 84.3% were hypertensive, 39.3% were diabetic, 7.9% were chronic kidney disease patients, 5.6% had a history of cerebrovascular accident. 3.4% had post procedural moderate paravalvular regurgitation, 15.4% developed high degree atrioventricular block mandating permanent pacemaker implantation, 7.9% developed intraprocedural acute pulmonary edema, 6.7% developed post implantation cerebrovascular accident and 4.5% developed post procedural acute kidney injury. Conclusions: various type of complication can be encountered and should be managed promptly after Transcatheter aortic valve replacement, addressing and studying these complication should be encouraged worldwide as this procedure became a novel strategy in managing severe aortic stenosis, right heart catheterization for filling pressure measurement and controlling co-morbidities as diabetes and hypertension may decrease the incidence of transcatheter aortic valve replacement periprocedural complications.