{"id":"ba6f18eb3e69","type":"article","url":"https://hartvaat.nl/2026/09/29/complicaties-na-tavi-volgens-varc-3-incidentie-voorspellers-en-mortaliteit/","title":"Complicaties na TAVI volgens VARC-3: incidentie, voorspellers en mortaliteit","title_en":"Incidence and Predictors of Complications After Transcatheter Aortic Valve Implantation According to VARC-3 Criteria: A Systematic Review and Meta-Analysis.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American Heart Association","doi":"10.1161/JAHA.125.045455","source_url":"https://doi.org/10.1161/JAHA.125.045455","authors":["Federico Giacobbe","Francesco Bruno","Marco Brero","Pierre Meynet","Andrea Solano","Sergio Capoccia","Riccardo Pilia","Fabrizio D'Ascenzo","Federico Conrotto","Giuseppe Tarantini","Michele la Torre","Won-Keun Kim","Andrea Buono","Johannes Blumenstein","Amin Polzin","Marco Gennari","Jonas M D Gmeiner","Antonio Piperata","Hendrik Ruge","Jie Li","Julia Mascherbauer","Ron Waksman","Israel Barbash","Gilbert Tang","Tomasz Gasior","John Webb","Hirofumi Hioki","Daniel Obaid","Antonio Mangieri","Gabriele Crimi","Michael Joner","Stefan Toggweiler","Victor Mauri","Mao-Shin Lin","Stephan Haussig","Marisa Avvedimento","Shane Nanayakkara","Patrick W Serruys","Quentin Landolff","Azeem Latib","Josep Rodes-Cabau","Gaetano Maria De Ferrari","Ovidio de Filippo"],"significance":6,"published":"2026-10-07","source_date":"2026-09-29","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/esc-richtlijn-kleplijden-2021/","https://hartvaat.nl/kennis/cardiometabool/obstructief-slaapapneu-en-hart/"],"congress":"","summary_en":"This systematic review and meta-analysis of 57 studies (73,588 patients) quantifies the incidence and predictors of complications after TAVI using the current VARC-3 criteria. Technical success reached 95%, with permanent pacemaker implantation (13%), major bleeding (9.7%), and acute kidney injury (4.7%) being the most frequent adverse events. Periprocedural kidney injury, bleeding, and non-structural valve dysfunction were strongly associated with 12-month mortality. These pooled data provide cardiologists with contemporary complication benchmarks to guide patient selection and peri-procedural risk management.","created":"2026-09-30T01:18:07Z","updated":"2026-09-30T01:18:07Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze systematische review en meta-analyse van 57 studies (73.588 patiënten) brengt de incidentie en voorspellers van complicaties na TAVI in kaart volgens de recente VARC-3-criteria. De technische succesrate bedroeg 95%, terwijl permanente pacemakerimplantatie (13%), bloedingen (9,7%) en acute nierinsufficiëntie (4,7%) tot de meest voorkomende complicaties behoorden. Complicaties zoals nierinsufficiëntie, bloedingen en niet-structurele kleefdysfunctie bleken sterk geassocieerd met een hogere mortaliteit op 12 maanden. Deze data helpen cardiologen bij het inschatten van procedurele risico’s en het selecteren van patiënten voor TAVI.","abstract_original":"BACKGROUND: Despite continuous advancements in devices and techniques, transcatheter aortic valve implantation remains associated with complications impacting outcomes. In 2021, the Valve Academic Research Consortium (VARC) introduced the VARC-3 criteria to better classify procedural complications. METHODS: We conducted a systematic review and meta-analysis of studies reporting transcatheter aortic valve implantation-related complications using VARC-3 definitions between 2021 and 2025. The primary end point was all-cause mortality at latest follow-up. Secondary end points included major VARC-3 complications and predictors of adverse events. RESULTS: A total of 57 studies with 73 588 patients were included. The cohort had a mean age of 81.7 years, 51.7% were women, and most had preserved ejection fraction (55.5%) and low-to-moderate surgical risk (Society of Thoracic Surgeons [STS] predicted risk of mortality [PROM] 4.1%). Technical and 30-day device success rates were 95% and 90%, respectively; early safety rate at 30 days was 66%. At average 12 months follow-up, all-cause mortality was 10.2%. The most common complication was permanent pacemaker implantation (13%), followed by type 2 or greater bleeding (9.7%), acute kidney injury stage 3-4 (4.7%), major vascular events (4.3%), and stroke (3.0%). Moderate/severe paravalvular regurgitation and patient-prosthesis mismatch occurred in 4% and 8%, respectively. Study-level pooled predictor analyses showed that acute kidney injury, type 2 or greater bleeding, paravalvular regurgitation, non-structural valve dysfunction, and higher STS score were associated with higher mortality, while eccentric/severe aortic valve calcification was associated with significant paravalvular regurgitation. CONCLUSIONS: Transcatheter aortic valve implantation shows high procedural success but non-negligible complication rates under VARC-3 criteria. acute kidney injury, type 2 or greater bleeding, NSVD, periprocedural stroke and myocardial infarction after transcatheter aortic valve implantation were associated with higher mortality."}