Our Experience in Transcatheter Aortic Valve Implantation (TAVI) from the Anesthesiologist's Perspective: A Single-Center Retrospective Study

Abstract

Objectives This study is aimed to review the perioperative complications, morbidity, and mortality rates of patients undergoing TAVI at our tertiary care hospital. Material and Methods The data for this retrospective study including 34 patients was collected from medical records of the patients. Statistical analyses were performed using SPSS 26 programme. The results were considered statistically significant at p<0.05. Results The study cohort, predominantly the elderly population (mean age 77.3 years), underwent TAVI under local anesthesia and sedation. Anesthetic induction involved fentanyl, ketamine and midazolam, with adjustments using propofol as needed. Hypotension emerged as the most common anesthesia-related complication. Importantly, the procedure was completed with conscious sedation in all cases that are not complicated by surgery, with no instances of respiratory complications. The most frequent procedure-related complication was atrioventricular bundle branch block. Postoperative outcomes demonstrated a significant reduction in aortic valve parameters, validating the efficacy of the procedure. Notably, the 30- and 90-day mortality rates were 0%, indicating favorable short-term survival. The study highlighted the importance of maintaining hemodynamic stability through vasopressors, with noradrenaline being the preferred choice. While the overall length of hospital stay averaged six days, the study emphasized the evolving landscape of TAVI, with shorter hospitalizations attributed to increasing procedural experience and refined anesthetic approaches. The need for permanent pacemaker was observed in 20% of cases. Conclusion This comprehensive analysis contributes valuable insights into the evolving field of TAVI, emphasizing the role of experienced anesthesiologists in optimizing patient outcomes. The study underscores the importance of refining anesthesia protocols, staying abreast of emerging guidelines and developing solution algorithms for emergency scenarios, ultimately enhancing the safety and efficacy of TAVI procedures in a rapidly expanding patient population.