Myocardial Injury Associated with Transcatheter Aortic Valve Implantation

Most patients have elevated cardiac enzyme markers after uncomplicated TAVI, but higher levels may be associated with worse outcomes.

Little is known about adverse myocardial effects of transcatheter aortic valve implantation (TAVI), which may arise from hypotension (due to balloon valvuloplasty or rapid pacing), tissue compression during deployment, or ventricular puncture during transapical access. In this single-center Canadian study, investigators measured cardiac enzymes at multiple time points up to 72 hours after TAVI of a balloon-expandable prosthesis in 101 patients, 63 of whom had transapical access. Patients who died within 24 hours or had life-threatening procedural complications were excluded from the analysis.

Seventy-seven percent of all patients — 47% of those with transfemoral insertions and 95% of those with transapical insertions — had elevated creatine …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)