Table 1 Considerations for decompensation after transcatheter aortic valve replacement include cardiac pathology, drug-related adverse effects, valve dysfunction, and pulmonary disease with diagnostic considerations based on suspected cause.
Acute Hemodynamic Decompensation during TAVR | |
|---|---|
Differential | Diagnostic and Treatment Considerations |
MI, CHF exacerbation, cardiac arrest, arrythmia, cardiac tamponade, acute cordae rupture, aortic dissection, annular rupture | Consider: 12-lead EKG, TTE, TEE |
Anaphylaxis, vasodilating medications, inhaled anesthetics | Verify medications & allergies, assess depth of anesthesia |
Valve migraton, valve embolization, valve malfunction | Consider: TEE, TTE, fluoroscopy |
Pulmonary embolism, acute pulmonary edema, pneumothorax, hemothorax, hypoventilation, hypoxemia | Consider: 12-lead EKG, TTE, TEE, auscultation, CXR |