“Thou shall not”……unless “thou” art in Germany!
The first commandment of transcatheter aortic valve implantation (TAVI) is that it should not be performed in the absence of an on-site cardiovascular surgery department. This position is enshrined in various recommendations and statements of national and international cardiology societies1-4. Although seemingly pedantic, it is important to distinguish between an “on-site surgical department” and “on-site surgery”. For the purposes of TAVI, the latter insinuates availability of surgical “back-up” for vascular access and/or the management of procedural complications, while the former implies a far more substantial contribution to patient care. ...
1. Department of Cardiology, Galway University Hospitals, Galway, Ireland; 2. Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands; 3. Department of Interventional Cardiology, McGill University Health Centre,
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