{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:16:41Z","timestamp":1792192601608,"version":"4.4.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Cardiac structural complications (CSCs) have been recently established by the Valve Academic Research Consortium 3 consensus as a combined end point including multiple life-threatening periprocedural events following transcatheter aortic valve replacement. The objective was to assess the incidence, timing, management, and clinical impact of CSCs in the contemporary transcatheter aortic valve replacement era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Multicenter study including consecutive patients undergoing transcatheter aortic valve replacement in 18 European and Canadian centers from 2014 to 2024. According to the Valve Academic Research Consortium 3 criteria, CSCs included cardiac structure perforation, injury or compromise, new pericardial effusion, and coronary obstruction. Data was collected in a dedicated database, and patients were followed at 30 days, 1 year, and yearly thereafter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among a total of 10\u2009541 patients, CSCs occurred in 221 (2.1%), with 126 (1.2%) patients exhibiting &gt;1 CSC: 146 (1.4%) cardiac structure compromise events (annular rupture: 41.1%, left ventricular perforation: 26.0%; right ventricular perforation: 24.0%, other injuries: 8.9%), 150 (1.4%) new pericardial effusions, and 59 (0.6%) coronary obstructions. Up to 75.6% of CSCs occurred intraprocedurally, and 61 (27.6%) patients had conversion to open heart surgery. The incidence of CSCs remained similar throughout the study period (from 1.3% to 3.2%, median annual rate of 2.3%). Thirty-day mortality was 35.3% (52.5% among patients requiring conversion to surgery), with annular rupture associated with the highest (41.0%) mortality rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>About 2% of contemporary transcatheter aortic valve replacement recipients presented CSCs, which did not decrease over time, required conversion to surgery in more than one-fourth of cases, and were associated with very high periprocedural mortality rates. Further research is needed regarding potential preventive strategies and optimal surgical bailout management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.125.015991","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:00:16Z","timestamp":1770285616000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Cardiac Structural Complications Following TAVR"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3828-8180","authenticated-orcid":true,"given":"Silvia","family":"Mas-Peiro","sequence":"first","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (S.M.-P., S.M., M.A., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4527-1694","authenticated-orcid":true,"given":"Guillem","family":"Muntan\u00e9-Carol","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, Barcelona, Spain (G.M.-C., R.R.)."},{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, Barcelona, Spain (G.M.-C., R.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9629-5864","authenticated-orcid":true,"given":"Julien","family":"Ternacle","sequence":"additional","affiliation":[{"name":"H\u00f4pital Cardiologique Haut-L\u00e9v\u00eaque, CHU de Bordeaux, Pessac, France (J.T., L.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5512-3820","authenticated-orcid":true,"given":"Gabriela","family":"Veiga","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Marques de Valdecilla, Santander, Spain (G.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1767-5963","authenticated-orcid":true,"given":"Victoria","family":"Vilalta","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Germans Trias i Pujol, Badalona, Spain (V.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1821-0658","authenticated-orcid":true,"given":"Francisco","family":"Campelo-Parada","sequence":"additional","affiliation":[{"name":"Cardiology Department, Toulouse University Hospital, France (F.C.-P., P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Nuche","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario 12 de Octubre. Instituto de Investigaci\u00f3n Sanitaria 12 de Octubre, Madrid, Spain (J.N., I.F.-H.)."},{"name":"Consorcio de Investigaci\u00f3n Biom\u00e9dica en Red - Cardiovascular (CIBER-CV), Madrid, Spain (J.N., I.F.-H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-8907","authenticated-orcid":true,"given":"Luis","family":"Nombela-Franco","sequence":"additional","affiliation":[{"name":"Cardiology Department, Instituto Cardiovascular, Hospital Clinico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico de San Carlos, Madrid, Spain (L.N.-F., G.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3357-5834","authenticated-orcid":true,"given":"Lluis","family":"Asmarats","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (L.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5201-447X","authenticated-orcid":true,"given":"Ander","family":"Regueiro","sequence":"additional","affiliation":[{"name":"Cardiology Department, Institut Cl\u00ednic Cardiovascular, Hospital Cl\u00ednic, Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS), Barcelona, Spain (A.R., I.A., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8276-7325","authenticated-orcid":true,"given":"Mar\u00eda","family":"Del Trigo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Puerta de Hierro, Madrid, Spain (M.d.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-6487","authenticated-orcid":true,"given":"Ciro","family":"Indolfi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Universit\u00e0 della Calabria, Rende, Cosenza, Italy (C.I., S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3174-8957","authenticated-orcid":true,"given":"Asim","family":"Cheema","sequence":"additional","affiliation":[{"name":"Southlake Regional Health Centre Newmarket, Ontario, Canada (A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7784-5501","authenticated-orcid":true,"given":"David","family":"del Val","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de La Princesa, Madrid, Spain (D.d.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9939-8949","authenticated-orcid":true,"given":"Alberto","family":"Alperi","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain (A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-7127","authenticated-orcid":true,"given":"Giovanni","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.E., A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mu\u00f1oz-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Regional Virgen de la Victoria, Malaga, Spain (A.M.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicen\u00e7","family":"Serra","sequence":"additional","affiliation":[{"name":"Cardiology Department, Vall d\u2019Hebron University Hospital, Barcelona, Spain (V.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6413-3502","authenticated-orcid":true,"given":"Rafael","family":"Romaguera","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, Barcelona, Spain (G.M.-C., R.R.)."},{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, Barcelona, Spain (G.M.-C., R.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7120-0470","authenticated-orcid":true,"given":"Lukas","family":"Weber","sequence":"additional","affiliation":[{"name":"H\u00f4pital Cardiologique Haut-L\u00e9v\u00eaque, CHU de Bordeaux, Pessac, France (J.T., L.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9934-8432","authenticated-orcid":true,"given":"Paul","family":"Gautier","sequence":"additional","affiliation":[{"name":"Cardiology Department, Toulouse University Hospital, France (F.C.-P., P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Fern\u00e1ndez-Herrero","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario 12 de Octubre. 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