Impact of lung diseases on morbidity and mortality after transcatheter aortic valve implantation: Insights from spirometry and body plethysmography

The utility of pulmonary function testing in the preoperative risk stratification of patients undergoing transcatheter aortic valve replacement

“…An argument can also be made to enhance the STS classification to account for the various forms of lung disease during preoperative stratification. If COPD remains as a predictor of postoperative outcomes in patients undergoing TAVR, more studies are needed using the more specific GOLD criteria for the classification of lung disease, as to prevent deterring patients who would benefit from surgical rescue . Until then, we suggest not to use COPD as a predictor of mortality.…”

Anesthetic Implications of Chronic Lung Disease in Patients Undergoing Transcatheter Valve Implantation

“…36 A recent analysis demonstrated that in addition to COPD, restrictive ventilatory disease (HR 2.252, p ¼ 0.002); oxygen dependency (HR 3.291, p ¼ 0.004); and noninvasive ventilation (HR 3.799, p ¼ 0.005) were independent predictors of long-term mortality after TAVI. 47 Restrictive lung disease has been reported in up to one-quarter of patients with severe AS. 47 Its impact on postoperative outcomes in TAVI patients has not been investigated in detail.…”

“…47 Restrictive lung disease has been reported in up to one-quarter of patients with severe AS. 47 Its impact on postoperative outcomes in TAVI patients has not been investigated in detail. A small study in 94 patients showed similar rates of in-hospital, 30-day, and 1-year mortality in patients with obstructive and restrictive pulmonary disease.…”

“…48 25 142 Propofol/ketamine 10-50 mg/kg/min 1% lidocaine subcutaneously Dexmedetomidine 0.3-0.7 mg/kg/h Midazolam up to 1 mg IV Oguri A, 2014 27 2,326 Sedation (not further defined) Local infiltration (not further defined) Dall'Ara, 2014 27 4,571 Sedation with target-controlled infusion of an anesthetic and/or opioid 1% lidocaine subcutaneously However, in patients with AS, restrictive lung disease has been associated with lower left ventricular ejection fraction, higher plasma brain natriuretic peptide levels, and pulmonary edema and should be considered a prognostic marker of mortality after TAVI. 47 A component of restriction and obstruction in patients with severe AS may be caused by pulmonary edema from congestive heart failure related to valvular disease. Studies indicated that patients' pulmonary function tests improved by 1 COPD severity category after TAVI in almost half of patients.…”

Does minimalist transfemoral transcatheter aortic valve replacement produce better survival in patients with severe chronic obstructive pulmonary disease?

“…Transcatheter aortic valve replacement (TAVR) has become a primary or alternative therapy to SAVR in inoperable and high surgical risk patients . Despite increase use of this technique , patients with severe chronic obstructive pulmonary disease (COPD) have worse outcomes than patients without or with less severe COPD . Previous studies have shown that minimalist TF‐TAVR results in short‐term results comparable to standard TF‐TAVR but with less resource utilization and cost .…”