Anesthesia management for 70 patients with transapical transcatheter aortic valve implantation surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XU Zhao ¹ , QIU Jingxuan ¹ , ZHU Da ² , CHEN Yucheng ³ , GUO Yingqiang ² , NI Hefeng ⁴ ,  LIANG Peng ¹

1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
3. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
4. Operating Room, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

LIANG Peng, Email: liangpeng_world@foxmail.com

Keywords：

Transapical approach; transcatheter aortic valve implantation; anesthesia management

DOI：

10.7507/1007-4848.201711035

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Objective To discuss the key points of anesthesia for patients undergoing transcatheter aortic valve implantation (TAVI) surgery. Methods We retrospectively collected and analyzed the data of 70 patients who underwent TAVI in the Department of Cardiovascular Surgery, West China Hospital from March 2014 to October 2015. There were 39 males and 31 females with an average age of 73.7±4.5 years. The perioperative preparation and anesthesia points of TAVI were summarized. Results All of the 70 included patients were aged and at high risk severe comorbidities such as ischemic heart disease and stroke. The aortic stenosis and regurgitation occurred in 39 and 31 patients respectively. No patients died during the surgery. The total success rate was 95.7%. Conclusion TAVI is a complex procedure for high risk patients and need more attention during anesthesia. The successful conduction of the procedure requires the whole team to prepare carefully and cooperate closely.

Citation： XU Zhao, QIU Jingxuan, ZHU Da, CHEN Yucheng, GUO Yingqiang, NI Hefeng, LIANG Peng. Anesthesia management for 70 patients with transapical transcatheter aortic valve implantation surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(8): 701-706. doi: 10.7507/1007-4848.201711035 Copy

1.	陈永聪, 赖可可. 经导管主动脉瓣置入术的麻醉. 心血管病防治知识(下半月), 2015, 11: 88-90.
2.	Thomas M, Schymik G, Walther T, et al. Thirty-day results of the SAPIEN aortic Bioprosthesis European Outcome (SOURCE) Registry: A European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation, 2010, 122(1): 62-69.
3.	陈辉, 马宇, 邓小明, 等.全身麻醉下经导管人工主动脉瓣植入术的麻醉管理.上海医学,2015, 38(2):157-158.
4.	Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
5.	Reardon MJ. Cost-effectiveness analysis of TAVR. Methodist Debakey Cardiovasc J, 2012, 8(2): 26-28.
6.	Di Mario C, Eltchaninoff H, Moat N, et al. The 2011-12 pilot European Sentinel Registry of Transcatheter Aortic Valve Implantation: in-hospital results in 4,571 patients. EuroIntervention, 2013, 8(12): 1362-1371.
7.	Cobey FC, Ferreira RG, Naseem TM, et al. Anesthetic and perioperative considerations for transapical transcatheter aortic valve replacement. J Cardiothorac Vasc Anesth, 2014, 28(4): 1075-1087.
8.	Biancari F, Rosato S, D’Errigo P, et al. Immediate and intermediate outcome after transapical versus transfemoral transcatheter aortic valve replacement. Am J Cardiol, 2016, 117(2): 245-251.
9.	Mukherjee C, Walther T, Borger MA, et al. Awake transapical aortic valve implantation using thoracic epidural anesthesia. Ann Thorac Surg, 2009, 88(3): 992-994.
10.	Fassl J, Walther T, Groesdonk HV, et al. Anesthesia management for transapical transcatheter aortic valve implantation: a case series. J Cardiothorac Vasc Anesth, 2009, 23(3): 286-291.
11.	Jayasuriya C, Moss RR, Munt B. Transcatheter aortic valve implantation in aortic stenosis: the role of echocardiography. J Am Soc Echocardiogr, 2011, 24(1): 15-27.
12.	Tam DY, Jones PM, Kiaii B, et al. Salvaging catastrophe in transcatheter aortic valve implantation: rehearsal, preassigned roles, and emergency preparedness. Can J Anaesth, 2015, 62(8): 918-926.
13.	Fernandes P, Cleland A, Bainbridge D, et al. Development of our TAVI protocol for emergency initiation of cardiopulmonary bypass. Perfusion, 2015,30(1): 34-39.

1. 陈永聪, 赖可可. 经导管主动脉瓣置入术的麻醉. 心血管病防治知识(下半月), 2015, 11: 88-90.
2. Thomas M, Schymik G, Walther T, et al. Thirty-day results of the SAPIEN aortic Bioprosthesis European Outcome (SOURCE) Registry: A European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation, 2010, 122(1): 62-69.
3. 陈辉, 马宇, 邓小明, 等.全身麻醉下经导管人工主动脉瓣植入术的麻醉管理.上海医学,2015, 38(2):157-158.
4. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
5. Reardon MJ. Cost-effectiveness analysis of TAVR. Methodist Debakey Cardiovasc J, 2012, 8(2): 26-28.
6. Di Mario C, Eltchaninoff H, Moat N, et al. The 2011-12 pilot European Sentinel Registry of Transcatheter Aortic Valve Implantation: in-hospital results in 4,571 patients. EuroIntervention, 2013, 8(12): 1362-1371.
7. Cobey FC, Ferreira RG, Naseem TM, et al. Anesthetic and perioperative considerations for transapical transcatheter aortic valve replacement. J Cardiothorac Vasc Anesth, 2014, 28(4): 1075-1087.
8. Biancari F, Rosato S, D’Errigo P, et al. Immediate and intermediate outcome after transapical versus transfemoral transcatheter aortic valve replacement. Am J Cardiol, 2016, 117(2): 245-251.
9. Mukherjee C, Walther T, Borger MA, et al. Awake transapical aortic valve implantation using thoracic epidural anesthesia. Ann Thorac Surg, 2009, 88(3): 992-994.
10. Fassl J, Walther T, Groesdonk HV, et al. Anesthesia management for transapical transcatheter aortic valve implantation: a case series. J Cardiothorac Vasc Anesth, 2009, 23(3): 286-291.
11. Jayasuriya C, Moss RR, Munt B. Transcatheter aortic valve implantation in aortic stenosis: the role of echocardiography. J Am Soc Echocardiogr, 2011, 24(1): 15-27.
12. Tam DY, Jones PM, Kiaii B, et al. Salvaging catastrophe in transcatheter aortic valve implantation: rehearsal, preassigned roles, and emergency preparedness. Can J Anaesth, 2015, 62(8): 918-926.
13. Fernandes P, Cleland A, Bainbridge D, et al. Development of our TAVI protocol for emergency initiation of cardiopulmonary bypass. Perfusion, 2015,30(1): 34-39.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Anesthesia management for 70 patients with transapical transcatheter aortic valve implantation surgery

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