Managing complications in transcatheter aortic valve implantation.

D uring the last decade, transcatheter aortic valve implantation (TAVI) has expanded the frontiers of interventional cardiology and gained a firm position in the therapeutic quiver for severe aortic stenosis. While the TAVI boom already amounts to more than 100,000 procedures worldwide,1 its recent (2014) inclusion in the American Heart Association/American College of Cardiology guidelines for the management of valvular heart disease,2 in accordance with the respective European ones (2012),3 should open new windows in the management of patients with aortic stenosis. Even though TAVI is generally a relatively safe procedure, heart teams must be prepared to tackle potential obstacles. Current experience has shown that the complications associated with TAVI include vascular complications, paravalvular regurgitation, conduction abnormalities requiring permanent pacemaker (PPM) implantation, acute kidney injury, and transient ischemic attack or stroke.4-8 In the present article we focus on the management of these TAVI complications.