This narrative review outlines contemporary strategies for preventing, recognizing, and managing major complications following transcatheter aortic valve replacement (TAVR). It emphasizes the critical role of multidetector CT for anatomical planning, including assessment of annular/LVOT calcium, coronary obstruction risk, and vascular access, while detailing the management of key procedural complications such as annular injury, paravalvular leak, tamponade, and dynamic LVOT obstruction. The authors also stress the importance of prolonged post-procedural surveillance for delayed events. The article serves as a practical reference for structural heart teams aiming to optimize TAVR safety and outcomes.
This review summarizes contemporary prevention, recognition, and management of major complications after transcatheter aortic valve replacement. The article emphasizes anatomy-specific planning with multidetector computated tomography (CT) to assess annular and left ventricular outflow tract (LVOT) calcium, coronary obstruction risk, aortic root dimensions, access quality, and factors affecting valve selection and deployment. It reviews key complications including annular and aortic root injury, coronary obstruction, valve malposition or embolization, paravalvular regurgitation, ventricular perforation and tamponade, dynamic LVOT obstruction, mitral injury, and iatrogenic septal defects. The review also highlights the importance of postevent surveillance for delayed complications after apparent procedural stabilization.
