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The following is a summary of “Incidence, characteristics, and outcome of noncardiac surgery following transcatheter aortic valve implantation,” published in the October 2024 issue of Cardiology by Alotaibi et al.      

Planning noncardiac surgery after transcatheter aortic valve implantation (TAVI) presents challenges for patients due to potential complications.  

Researchers conducted a prospective study to evaluate the incidence and outcomes of noncardiac surgeries following TAVI.  

They retrieved data from the Prospective Segeberg TAVI registry, assessing the type, timing, urgency, and risk of noncardiac surgery in 1,602 patients who underwent TAVI (2007 and 2020). Clinical outcomes within 30 days included death, myocardial infarction, bleeding, stroke, and acute heart failure (P<0.047).  

The results showed 1,602 patients, 104 (mean age, 79.9 ± 7.14 years; 61 [58.7%] females) underwent 148 noncardiac surgeries after TAVI. More than half of these surgeries were elective (n = 84, 56.7%), categorized as low-risk (n = 27, 18.2%), intermediate-risk (n = 102, 68.9%), and high-risk (n = 19, 12.8%). The AEs occurred after 57 surgeries (38.5% of all procedures), with more than half of the AEs occurring in the high-risk category (n = 11, 57.9%). Major or life-threatening bleeding occurred in 24 surgeries (19.1%), with higher frequency in high-risk surgeries (36.8%, P<0.047). High-risk surgery was independently associated with an increased risk of the composite outcome (aOR, 3.99; 95% CI, 1.12–14.23; P=0.033).  

They concluded that noncardiac surgery after TAVI was performed in 6.5% patient of the study cohort, with high-risk noncardiac surgeries associated with a greater risk of AEs.  

Source: link.springer.com/article/10.1007/s00392-024-02533-z