Chapter XV. Complications of Transcatheter Aortic Valve Implantation.

Transcatheter aortic valve implantation (TAVI) is emerging as a valuable procedure to treat patients with severe aortic valve stenosis at high risk or not candidate for conventional aortic valve replacement. Besides obvious shortcomings related to the learning curve, adverse events do occur because of the inherent features of TAVI strictly linked to the application of the procedure as well as of the preoperative patient clinical profiles and comorbidities. These complications may profoundly affect procedural success rate as well as patient outcome at early and mid-term. Despite recent improvements due to advances in technological components as well as in transcatheter procedural management, several complications are still critical issues, and some may not be reduced by better device design or improved procedural strategies. Thorough awareness, therefore, of the prevalence and type of adverse events, potential predisposing factors or determinants, and management strategies to treat them once occurred, might be crucial to allow further improvement in patient outcome and reduce negative results, either in hospital or post discharge. This chapter will provide an overview about prevalence and features of TAVI complications, with particular emphasis on the impact on patient outcome and some insights about management as well as preventing strategies.