Multisociety (AATS, ACCF, SCAI, and STS) Expert Consensus Statement: Operator and Institutional Requirements for Transcatheter Valve Repair and Replacement, Part 1: Transcatheter Aortic Valve Replacement
Division of Cardiology, NorthShore University HealthSystem, Skokie Hospital, Skokie, Illinois 60076, USA.Journal of the American College of Cardiology (Impact Factor: 16.5). 02/2012; 59(22):2028-42. DOI: 10.1016/j.jacc.2012.02.016
Article: 2012 ACCF/AATS/SCAI/STS Expert Consensus Document on Transcatheter Aortic Valve Replacement Developed in collaboration with the American Heart Association, American Society of Echocardiography, European Association for CardioThoracic Surgery, Heart Failure Society of America, Mended Hearts, Society of Cardiovascular Anesthesiologists, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance
Article: Room considerations with TAVR[Show abstract] [Hide abstract]
ABSTRACT: While transcatheter aortic valve replacement is considered a viable alternative to traditional surgery for patients with critical aortic stenosis, it is still a cardiac surgical procedure with a steep learning curve. Space consideration is a key aspect of the procedure's success. A TAVR program requires the commitment from and investment of institutional resources, the outfitting of an appropriate procedure room, and meticulous training of a multidisciplinary TAVR team. Careful integration of the various imaging modalities, medical specialties, and equipment is necessary to ensure the safety and efficacy of the procedure and to treat complications that may arise.
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ABSTRACT: After its first introduction in 2002, transcatheter aortic valve implantation (TAVI) has continuously gained more foothold for the treatment of severe aortic stenosis and is nowadays a viable treatment option for inoperable patients or patients at high risk for conventional surgical aortic valve replacement. Although ideally carried out in a so-called hybrid room, incorporating both the strict hygiene and advanced life support possibilities of the operating theatre and the imaging and percutaneous arsenal of the catheterisation suite, in most centres TAVI is at present performed in the catheterisation laboratory. This may raise concern about an increased risk of infection, since there the criteria that are applied regarding disinfection and sterilisation are not as stringent as those of the operating theatre. Therefore, we retrospectively assessed the number of infective complications in patients undergoing TAVI in the catheterisation lab of our institution. Eleven out of 73 patients developed a postprocedural infection, one of which could be attributed to the procedure itself, being superinfection of a surgical groin cut-down. Our conclusion is that percutaneous aortic valve implantation in a catheterisation laboratory is not associated with an increased risk of infective complications.
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