Percutaneous aortic valve implants under sedation

Basciani, Reto; Eberle, Balthasar

doi:10.1002/ccd.22026

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…The most important consideration for the anesthesiologist member of the care team is the type of anesthesia most suited for the patient. The choice of anesthesiologic management is different among hospitals, but it is generally based on preoperative comorbidities, procedural approach used for TAVR and even hospital logistics [14][15][16][17][18] . Some centers used to perform TAVR under general anesthesia (GA), some else under local anesthesia with a mild sedation (LAS), some of them start their TAVR program under GA, but convert in LAS when the team get enough experience.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter aortic valve replacement: is anesthesiologic management linked to surgical outcomes?

Candela¹,

Pumpo²,

Centonze³

et al. 2018

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Aortic valve replacement (AVR) is the current standard treatment for severe aortic stenosis, nonetheless, many patients are not suitable to AVR because of high risk related to advanced age, impaired cardiac function, or comorbidities. Given these considerations, transcatheter aortic valve replacement or implantation (TAVR or TAVI) has emerged in the last decade as an alternative to surgery and has become the treatment of choice for severe aortic stenosis in patients with prohibitive surgical risk. In the context of this kind of hybrid procedure, the anesthesiologist plays a central role because the choice of anesthetic technique is strongly related to clinical features of the patients and technical considerations, which must be discussed collegially with the surgeons. The choice of anesthesiologic management is different among hospitals, but it is generally based on preoperative comorbidities, procedural approach used for TAVR and even hospital logistic. Some centers used to perform TAVR under general anesthesia (GA), some else under local anesthesia plus sedation (LAS), some of them start their TAVR program under GA, but convert in LAS when the team get enough experience. Also, anesthesiologists involved in TAVR procedures must be part of a "heart team", and should be confident with anesthesia for cardiovascular surgery, mechanical circulatory support, and with transesophageal echocardiography. The aim of this article is to provide a general overview about anesthetic techniques in TAVR and to evaluate pathways for future researches.

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Section: Introductionmentioning

confidence: 99%

Transcatheter aortic valve replacement: is anesthesiologic management linked to surgical outcomes?

Candela¹,

Pumpo²,

Centonze³

et al. 2018

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Cardio-anesthesiology considerations for the trans-catheter aortic valve implantation (TAVI) procedure

Melidi

Latsios

Toutouzas

et al. 2016

Hellenic Journal of Cardiology

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Transcatheter aortic valve implantation (TAVI) has become the mainstay for high-risk or inoperable patients with symptomatic aortic valve stenosis, and research regarding the use of transcatheter valves in intermediate or low-risk patients is currently ongoing. The aim of this article is to provide comprehensive insight into the anesthetic management of patients undergoing TAVI and to highlight possible gaps in the current knowledge. One important procedural characteristic that is imperative to consider is the type of anesthesia being used and its possible complications. Increasingly, experienced centers have changed from general anesthesia with endotracheal intubation to local anesthesia with sedation, especially when the transfemoral access route is used for TAVI. There is still debate regarding what type of anesthesia should be used in the procedure, and the lack of randomized data makes it even more challenging for the operators.

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Percutaneous aortic valve implants under sedation

Cited by 2 publications

References 23 publications

Transcatheter aortic valve replacement: is anesthesiologic management linked to surgical outcomes?

Transcatheter aortic valve replacement: is anesthesiologic management linked to surgical outcomes?

Cardio-anesthesiology considerations for the trans-catheter aortic valve implantation (TAVI) procedure

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