Comparison of left ventricular with right ventricular rapid pacing on tamponade during TAVI

Savvoulidis, Panagiotis; Mechery, Anthony; Lawton, Ewa; Ludman, Peter; Sharma, Harish; Thompson, S.; Khalil, Arsalan; Καλογερόπουλος, Ανδρέας; Khan, Sohail Q.; Nadir, Adnan; Doshi, Sagar N.

doi:10.1016/j.ijcard.2022.05.035

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…The examinations confirmed the absence of regional wall motion abnormality and intact coronary flow, allowing the surgeons to rule out mitral valve regurgitation resulting from papillary muscle ischemia. 3 It was also confirmed that acute severe mitral valve regurgitation was related to the LV pacing wire because the regurgitation improved immediately after the pacing wire was retrieved, and stable blood pressure was restored.…”

Section: Discussionmentioning

confidence: 81%

“…As part of this trend, LV rapid pacing is being implemented for transcatheter heart valve deployment because some studies suggest that it is safe, efficacious, and cost-effective compared with traditional right heart pacing and may represent a step forward in the overall simplification of TAVR procedures. 3 , 4 Apprehensions persist, however, regarding the safety of LV pacing, especially concerning potential issues such as loss of contact leading, the risk of embolization, and the possible increased risk of LV free-wall rupture.…”

Section: Discussionmentioning

confidence: 99%

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Acute Mitral Valve Regurgitation Caused by Left Ventricular Pacing Wire During Transcatheter Aortic Valve Replacement

Son,

Kim,

Nam

et al. 2024

Texas Heart Institute Journal

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Transcatheter aortic valve replacement is quickly becoming the standard of care for patients with severe aortic stenosis thanks to its minimally invasive nature and favorable outcomes. Recently, left ventricular pacing has been proposed as a safer alternative to traditional right heart pacing, which could simplify the transcatheter aortic valve replacement procedure overall, although procedural complications may still occur. This report describes a rare case of left ventricular pacing wire–induced acute severe mitral valve regurgitation during transcatheter aortic valve replacement.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Acute Mitral Valve Regurgitation Caused by Left Ventricular Pacing Wire During Transcatheter Aortic Valve Replacement

Son,

Kim,

Nam

et al. 2024

Texas Heart Institute Journal

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“… 13 Where some operators may prefer IJ venous access for more secure RV lead placement, others may prefer to persist with femoral placement of the pacing wire to ensure shorter procedure times—and only consider IJ pacing wire placement if there is confirmed conduction disturbance. Procedural time has been shown to be shortened by 7-13 minutes when RV pacing is not utilized 9 , 14 , 15 and total cost per-patient at 30 days is significantly reduced, driven by materials and cath lab time spared. 14 These combined benefits are important for cath lab efficiencies, budgets, patient access, and productivity as TAVR volumes continue to rise.…”

Section: Discussionmentioning

confidence: 99%

Best Practices in Left Ventricular Pacing for Transcatheter Aortic Valve Replacement

Blusztein¹,

Raney²,

Walsh³

et al. 2023

Structural Heart

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“…All cases were undertaken with conscious sedation and transthoracic ultrasound monitoring 5 . In all cases valvuloplasty and transcatheter heart valve (THV) deployment were undertaken with rapid pacing via the 0.035″ delivery catheter wire 6 . Activated clotting time (ACT) was maintained at 250–300 s throughout the procedure.…”

Section: Methodsmentioning

confidence: 99%

Routine postaccess‐closure angiography to detect vascular complications following transfemoral TAVR

Savvoulidis,

Nadir,

Mechery

et al. 2023

Cathet Cardio Intervent

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BackgroundVascular complications following transfemoral TAVR are associated with increased morbidity and mortality. Measures that may mitigate this risk are important.AimTo evaluate the utility of routine, access‐vessel angiography post sheath‐removal in the detection and management of complications in patients undergoing transcatheter aortic valve replacement (TAVR).MethodsThis was a retrospective study of 512 consecutive patients who underwent transfemoral TAVR with routine post access‐closure angiography from the radial artery. Rates of mild angiographically evident bleeding, bleeding requiring surgery/interventional‐radiology, ischemia, 90‐day access‐site‐related events, and major and minor vascular complications using Valve Academic Research Consortium 3 definitions were recorded.ResultsOf 512 patients, digital subtraction angiography (DSA) was undertaken via the radial artery in 467 patients (91%). In the remaining patients (9%) DSA was either not attempted, due to concerns regarding kidney disease and contrast volume, or failed due to anatomical factors (aortic tortuosity/calcification). Significant chronic kidney disease was present at baseline in 72.4% of this cohort (stages III–IV or dialysis). Ninety‐four percent of cases underwent TAVR using a balloon‐expandable platform. Mild iliofemoral extravasation was observed in 7.7% of the DSA cases. These cases were managed by manual compression with none requiring any vascular intervention subsequently. Valve Academic Research Consortium 3 major and minor access‐site‐related complications were observed in 0.4% and 12.2%, respectively. Access‐site‐related bleeding and ischemic events requiring interventional‐radiology or vascular‐surgery were observed in 0.9% and 1.7% of the DSA cases, respectively. No new renal replacement therapy was needed in any of the DSA cases. Discharge to 90‐day access‐related complications was 0.8%.ConclusionsRoutine post access‐closure angiography is feasible via the radial artery in patients undergoing transfemoral TAVR and appears safe. It facilitates early identification of complications and mitigates risk by enabling prompt action to be taken. Larger studies are needed to confirm these findings.

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Comparison of left ventricular with right ventricular rapid pacing on tamponade during TAVI

Cited by 10 publications

References 13 publications

Acute Mitral Valve Regurgitation Caused by Left Ventricular Pacing Wire During Transcatheter Aortic Valve Replacement

Acute Mitral Valve Regurgitation Caused by Left Ventricular Pacing Wire During Transcatheter Aortic Valve Replacement

Best Practices in Left Ventricular Pacing for Transcatheter Aortic Valve Replacement

Routine postaccess‐closure angiography to detect vascular complications following transfemoral TAVR

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