Effect of thoracic epidural analgesia on clinical outcomes following transapical transcatheter aortic valve implantation

Amat‐Santos, Ignacio J.; Dumont, Éric; Villeneuve, Jacques; Doyle, D. John; Rheault, Michel; Lavigne, Dominique; Lemieux, J M; St-Pierre, André; Mok, Michael; Ureña, Marina; Nombela‐Franco, Luis; Blackburn, S.; Simon, Mathieu; Bourgault, Christine; Carrasco, José Luís; Pîbarot, Philippe; Côté, Mélanie; DeLarochellière, Robert; Cohen, David J.; Rodés‐Cabau, Josep

doi:10.1136/heartjnl-2012-302185

Cited by 44 publications

(17 citation statements)

References 33 publications

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“…As opposed to TF approach, general anesthesia and surgical dissection were more often employed in patients undergoing TSc TAVI. The prognostic impact of such difference is unknown even among TF cases, including surgical versus fully percutaneous and local versus general anesthesia . Nevertheless, local anesthesia in combination with mild systemic sedative/analgesic treatment has been successfully used in TSc series and, more recently, the development of fully percutaneous approach, also feasible under local anesthesia and with promising results, has simplified the technique making it comparable to transfemoral approach (Supporting Information Video 1).…”

Section: Discussionmentioning

confidence: 99%

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Amat‐Santos

Rojas

Gutiérrez

et al. 2018

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 99%

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Amat‐Santos

Rojas

Gutiérrez

et al. 2018

Cathet Cardio Intervent

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“…However, since the transfemoral approach was favoured in the FRANCE 2 registry, transapical and other approaches were likely to be used in sicker patients. In addition, the modalities of pain control influence postprocedural mortality 22. Even a multivariate analysis cannot control for all potential known and unknown confounding factors in this setting.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of early mortality after transcatheter aortic valve implantation: individual risk assessment using a simple score

Iung

Laouénan²,

Himbert³

et al. 2014

Heart

191

129

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“…Procedural modification and localized administration of analgesia may provide some HRQoL benefit in patients undergoing TA-TAVR. 24 However, these maneuvers do not eliminate the apical puncture and repair inherent to the TA approach, which could adversely impact left ventricular function and cause subsequent functional limitation. 25 …”

Section: Discussionmentioning

confidence: 99%

Temporal Trends in Quality of Life Outcomes After Transapical Transcatheter Aortic Valve Replacement

Gada

Kirtane

Wang

et al. 2015

Circ: Cardiovascular Quality and Outcomes

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Background In the PARTNER randomized controlled trial (RCT), which represented the first exposure to transapical transcatheter aortic valve replacement (TA-TAVR) for many clinical sites, high risk patients undergoing TA-TAVR derived similar health-related quality-of-life (HRQoL) outcomes when compared with surgical AVR (SAVR). With increasing experience, it is possible that HRQoL outcomes of TA-TAVR may have improved. Methods and Results We evaluated HRQoL outcomes at 1-, 6-, and 12-month follow-up among 875 patients undergoing TA-TAVR in the PARTNER non-randomized continued access (NRCA) registry, and compared these outcomes with those of the TA-TAVR and SAVR patients in the PARTNER RCT. HRQoL was assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Medical Outcomes Study Short Form-12, and the EuroQoL-5D, with the KCCQ overall summary score serving as the primary endpoint. The NRCA TA-TAVR and RCT TA-TAVR and SAVR groups were generally similar. The primary outcome, the KCCQ summary score, did not differ between the NRCA TA-TAVR and the RCT TA-TAVR group at any follow-up timepoints, although there were small differences in favor of the NRCA cohort on several KCCQ subscales at 1 month. There were no significant differences in follow-up HRQOL between the NRCA-TAVR and the RCT SAVR cohorts on the KCCQ overall summary scale or any of the disease-specific or generic subscales. Conclusions Despite greater experience with TA-TAVR in the NRCA registry, HRQoL outcomes remained similar to those of TA-TAVR in the original RCT cohort and no better than those with SAVR. These findings have important implications for patient selection for TAVR when transfemoral access is not an option. Clinical Trial Registration Placement of AoRTic TraNscathetER Valve [PARTNER] trial; NCT00530894; http://clinicaltrials.gov/show/NCT00530894

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Effect of thoracic epidural analgesia on clinical outcomes following transapical transcatheter aortic valve implantation

Cited by 44 publications

References 33 publications

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Predictive factors of early mortality after transcatheter aortic valve implantation: individual risk assessment using a simple score

Temporal Trends in Quality of Life Outcomes After Transapical Transcatheter Aortic Valve Replacement

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