Youssef Fathy Mohamed Nosir
Cardiology Department KFAFH, Saudia Arabia
Title: TEE monitoring TAVI can detect procedure complications that allow early management for favorable clinical outcome, KFAFH experience
Biography
Biography: Youssef Fathy Mohamed Nosir
Abstract
TAVI is a relatively new procedure for replacing the non operable severely stenotic AV in elderly patients. TEE monitoring the procedure is still questionable. At KFAFH, Jeddah, KSA, TEE was performed during TAVI procedure to re-measure the annulus size and to monitor all procedure steps. 47 patients underwent TAVI procedure at KFAFH between 20112 and 2015. The procedure was successful in all patients. TEE could detect 9 acute complications during the procedure that were managed immediately. 1- One acute fresh mobile thrombus was detected over the catheter in LV after balloon dilatation. The catheter was removed with the thrombus thread over it. 2- Acute severe MR in 4 patients TEE could detect the cause, one was due to acute ischemia and 3 were due to distal displacement of posterior MV leaflet by the LV catheter. MR was disappeared after dealing with the cause. 3- Pericardial effusion was detected immediately post procedure in 3 cases that necessitate tapping. 4- Acute severe hypotension immediately following valve deployment during rapid pacing was detected in one patient. TEE revealed acute severe LV systolic dysfunction with SWMA related to distal LAD segments and development of severe MR. Immediate coronary angiography revealed acute LM stenosis and primary stenting was performed with DES. After LM stenting LV systolic function improved and MR was disappeared. In conclusion TEE is recommended to monitor TAVI procedure for early detection of acute complication during the procedure that allow immediate and proper management of complication for favorable clinical outcomes.