Aims: Transoesophageal echocardiography (TEE) may require patient sedation, eventually leading to respiratory depression, a risky condition in severe cardiac disease. Non-invasive ventilation (NIV) has been applied during diagnostic manoeuvres, but its use during TEE has not been reported. We describe NIV-aided continuous TEE monitoring under sedation in the supine position in three consecutive orthopnoeic patients with severe aortic valve stenosis: two of them underwent percutaneous aortic valve implantation, and one underwent aortic valvuloplasty.
Methods And Results: The TEE probe was passed through a hole performed with a surgical cutter in an NIV face-mask. Pulsoximetry, heart rate, arterial blood pressure, respiratory rate, arterial blood gases, patients' comfort, and patient's sedation were monitored throughout the procedure. Percutaneous aortic valve implantation procedures lasted almost 2 h, while the valvuloplasty procedure lasted 70 min. Non-invasive ventilation and continuous TEE were performed throughout the procedures without technical problems or respiratory or haemodynamic complications, and all patients felt always comfortable.
Conclusion: Non-invasive ventilation through a modified face-mask allowed to perform continuous TEE examination and to avoid tracheal intubation and general anaesthesia in three high-risk patients undergoing beating heart treatment of aortic valve stenosis.
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http://dx.doi.org/10.1093/ejechocard/jeq019 | DOI Listing |
Angiology
January 2025
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
This meta-analysis evaluates outcomes in patients undergoing bioprosthetic aortic valve replacement (bAVR), comparing different antithrombotic strategies. We conducted a systematic search through May 2024. A standard meta-analysis compared outcomes between patients who received anticoagulation therapy (AC) and those who did not.
View Article and Find Full Text PDFCirc Cardiovasc Interv
January 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, DC (R.V., K.R.C., I.M., I.B.-D., L.F.S., R.W., T.R.).
Some patients with aortic stenosis may require multiple valve interventions in their lifetime, and choosing transcatheter aortic valve replacement (TAVR) as the initial intervention may be appealing to many. If their transcatheter heart valve degenerates later in life, most will hope to undergo redo-TAVR. However, if redo-TAVR is not feasible, some may have to undergo surgical explantation of their transcatheter heart valve (TAVR-explant).
View Article and Find Full Text PDFInt J Cardiol Heart Vasc
February 2025
Faculty of Medicine, Tanta University, Tanta, Egypt.
Background: Aortic stenosis (AS) remains a prevalent and serious global health concern, exacerbated by an aging population worldwide. This valvular disease, when symptomatic and without appropriate intervention, severe AS can drastically reduce life expectancy. In our systematic review and -analysis, we aim to synthesize available evidence to guide clinical decision-making by comparing the performance of TAVR and SAVR, specifically in patients with severe AS and a small aortic annulus.
View Article and Find Full Text PDFSevere aortic valve stenosis poses a significant risk for the aging population, often escalating from mild symptoms to life-threatening heart failure and sudden death. Without timely intervention, this condition can lead to disastrous outcomes. The advent of transcatheter aortic valve implantation (TAVI) has gained popularity, emerging as an effective alternative for managing severe aortic stenosis (AS) in high-risk patients experiencing deterioration of previously implanted bioprosthetic surgical aortic valves (SAV), which introduces complex challenges such as device compatibility and anatomical considerations.
View Article and Find Full Text PDFJ Cardiol Cases
January 2025
Department of Cardiology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Unlabelled: Transcatheter aortic valve implantation (TAVI) procedure is a well-established therapeutic measure for severe aortic stenosis with expanding indications. We present a case of a patient who had undergone a TAVI procedure during cardiopulmonary resuscitation on the grounds of cardiogenic shock.
Learning Objectives: During the past decade, as platform and delivery technology regarding the implementation of transcatheter aortic valve implantation (TAVI) have improved, procedure indications expanded both to low and very high-risk patients.
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