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Predictors and Outcome of Conversion to Cardiac Surgery During Transcatheter Aortic Valve Implantation
Transcatheter aortic valve replacement (TAVR) periprocedural complications rate are low; however, those patients requiring conversion to surgery are under an increased mortality risk. Arsalan and colleagues evaluated 32 patients, 2.1% of 1775 total TAVR procedures at their center, who needed immediate conversion to sternotomy during the TAVR procedure. The most common reasons for conversion were annular rupture, device embolization, and pericardial tamponade. The only predictor for conversion was the usage of a self-expandable valve (OR 0.38, 95% CI 0.16 - 0.90, p = 0.03). Survival at 30 days was 56%, emphasizing the importance of an experienced heart team and access to emergency surgical procedures for these uncommon but unpredictable situations.