Abstract
BackgroundTranscatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat degenerative heart valve disease. The implantation requires a highly specific and interdisciplinary management approach. Currently, TAVI is performed with the patient under local or general anaesthesia.MethodsThis study was a retrospective analysis of all TAVI procedures performed at the University Hospital of Regensburg between January 2009 and July 2015. All pre-, intra and postoperative data focusing on perioperative complications were recorded.ResultsA total of 853 transfemoral- and transapical-TAVI patients were included in the study. All patients underwent general anaesthesia. The ASA classifications were primarily 3–4. The average logistic EuroScores for the transfemoral- and transapical-TAVI patients were 18 ± 12% and 21 ± 15% (p = 0.002), respectively. The anaesthesia coverage time was 170 ± 49 min., including 37 ± 12 minutes for anaesthetic management. Overall, 458 complications were recorded; with pneumonia, acute renal failure, indication for a permanent pacemaker and non-extubation in the operating theatre the most frequently recorded complications.ConclusionIn the present study, we showed that our patients’ outcomes are comparable to those reported in the available literature. Compared to TF, TA patients show an overall worse physical condition as well as a higher perioperative morbidity and mortality. Consequently TA patients need additional care and should only be operated in appropriately experienced medical centres.
Highlights
Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgical procedure that was initially developed as an alternative treatment for patients with a high level of perioperative risk, and it has since established itself in this field
[8] Because the number of surgical interventions remained virtually constant during this time, TAVI was used for patients for whom only a conservative approach had been previously available
While the first TAVI was performed under monitored anaesthetic care (MAC), general anaesthesia (GA) was typically utilized in the early years
Summary
The most common form of heart valve disease in western countries is aortic valve stenosis. [1] Its prevalence among patients older than 65 years of age is 2% to 7%. [2] Etiologically, the most common cause is valve calcification. [1] Surgical aortic valve replacement is currently the gold standard for treating aortic valve stenosis in low- or intermediate-risk patients. [3]Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgical procedure that was initially developed as an alternative treatment for patients with a high level of perioperative risk, and it has since established itself in this field. [4] TAVI involves the implantation of a prosthetic valve mounted on a stent and introduced with a catheter through transfemoral (TF), transapical (TA), transaxillary/subclavian or direct transaortic access. [5] Usually, the TF approach is preferred, because thoracotomy and penetration of the myocardium are not needed. The most common form of heart valve disease in western countries is aortic valve stenosis. [1] Surgical aortic valve replacement is currently the gold standard for treating aortic valve stenosis in low- or intermediate-risk patients. Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgical procedure that was initially developed as an alternative treatment for patients with a high level of perioperative risk, and it has since established itself in this field. [7] In recent years, TAVIs, through TF access, have often been performed under local anaesthesia and MAC in Germany. Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat degenerative heart valve disease. TAVI is performed with the patient under local or general anaesthesia
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
