# Complicaties na TAVI volgens VARC-3: incidentie, voorspellers en mortaliteit

*geplaatst 2026-10-07 · Algemeen · Journal of the American Heart Association · doi 10.1161/JAHA.125.045455 · https://hartvaat.nl/2026/09/29/complicaties-na-tavi-volgens-varc-3-incidentie-voorspellers-en-mortaliteit/*

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.

## English: Incidence and Predictors of Complications After Transcatheter Aortic Valve Implantation According to VARC-3 Criteria: A Systematic Review and Meta-Analysis.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Journal of the American Heart Association, https://doi.org/10.1161/JAHA.125.045455. Bijgewerkt 2026-09-30T01:18:07Z. 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.