{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:27:56Z","timestamp":1789457276747,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T00:00:00Z","timestamp":1680825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>During a transcatheter aortic valve implant (TAVI) procedure, intraprocedural complications that are manageable only by conversion to emergency open-heart surgery (E-OHS) occasionally occur. Contemporary data on the incidence and outcome of TAVI patients undergoing E-OHS are scarce. This study aimed to evaluate early and midterm outcomes following E-OHS of patients undergoing TAVI in a large tertiary care centre with immediate surgical backup availability for all TAVI procedures over a 15-year period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Data from all patients undergoing transfemoral TAVI between 2006 and 2020 at the Heart Centre Leipzig were analysed. The study time was divided into 3 periods: 2006\u20132010 (P1), 2011\u20132015 (P2) and 2016\u20132020 (P3). Patients were grouped according to their surgical risk (high risk: EuroSCORE II \u2265 6%; low\/intermediate risk: EuroSCORE II &amp;lt;6%). Primary outcomes were intraprocedural and in-hospital death and 1-year survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>During the study period, a total of 6903 patients underwent transfemoral TAVI. Among them, 74 (1.1%) required E-OHS [high risk, n\u2009=\u200966 (89.2%); low\/intermediate risk, n\u2009=\u20098 (10.8%)]. The rate of patients requiring E-OHS was 3.5% (20\/577 patients), 1.8% (35\/1967 patients) and 0.4% (19\/4359 patients) in study periods P1 to P3, respectively (P\u2009&amp;lt;\u20090.001). The proportion of patients who had E-OHS who were low\/intermediate risk increased considerably over time (P1:0%; P28.6%; P3:26.3%; P\u2009=\u20090.077). Intraprocedural deaths occurred in 10 patients (13.5%), all of whom were high-risk. In-hospital mortality was 62.1% in high-risk patients and 12.5% in low\/intermediate risk patients (P\u2009=\u20090.007). One-year survival was 37.8% in all patients undergoing E-OHS, 31.8% in high-risk patients and 87.5% in low\/intermediate risk patients (log-rank P\u2009=\u20090.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In-hospital and 1-year survival rates following E-OHS are higher in low\/intermediate risk than in high-risk patients undergoing TAVI. An on-site cardiac surgical department with immediately available E-OHS capabilities is an important component of the TAVI team.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad142","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T16:09:41Z","timestamp":1680883781000},"source":"Crossref","is-referenced-by-count":14,"title":["Incidence and outcomes of emergency intraprocedural surgical conversion during transcatheter aortic valve implantation: Insights from a large tertiary care centre"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1000-4710","authenticated-orcid":false,"given":"Mateo","family":"Marin-Cuartas","sequence":"first","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"de Waha","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Naumann","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salil V","family":"Deo","sequence":"additional","affiliation":[{"name":"Louis Stokes Cleveland VA Medical Centre, Department of Veterans Affairs , Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5555-9616","authenticated-orcid":false,"given":"Jagdip","family":"Kang","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Noack","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandro","family":"Hoyer","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Holzhey","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Leontyev","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7449-9455","authenticated-orcid":false,"given":"Diyar","family":"Saeed","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Misfeld","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Meineri","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Anesthesiology , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Ender","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Anesthesiology , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abdel-Wahab","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiology , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Desch","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiology , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-998X","authenticated-orcid":false,"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiology , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-1364","authenticated-orcid":false,"given":"Michael A","family":"Borger","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,7]]},"reference":[{"key":"2023061302203614400_ezad142-B1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/ejcts\/ezab389","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"60","author":"Vahanian","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023061302203614400_ezad142-B2","first-page":"e35","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: 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shift","volume":"8","author":"Fraccaro","year":"2016","journal-title":"J Thorac Dis"},{"key":"2023061302203614400_ezad142-B11","doi-asserted-by":"crossref","first-page":"55","DOI":"10.15420\/icr.2015.10.1.55","article-title":"The Current Situation and the Future of Emergent Cardiac Surgery in TAVI","volume":"10","author":"Eggebrecht","year":"2015","journal-title":"Interv Cardiol"},{"key":"2023061302203614400_ezad142-B12","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/eurheartj\/ehx713","article-title":"Incidence and outcomes of emergent cardiac surgery during transfemoral transcatheter aortic valve implantation (TAVI): insights from the European Registry on Emergent Cardiac Surgery during TAVI (EuRECS-TAVI)","volume":"39","author":"Eggebrecht","year":"2018","journal-title":"Eur Heart J"},{"key":"2023061302203614400_ezad142-B13","doi-asserted-by":"crossref","first-page":"446","DOI":"10.4244\/EIJV9I4A73","article-title":"Outcome of patients after emergency conversion 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