Background And Objectives: Aortic stenosis is the most common type of heart valve disease. Percutaneous aortic valve replacement has become the alternative for patients considered at high risk for surgery. Controlled mechanical ventilation with tracheal intubation has been the choice for this type of procedure, however the use of noninvasive ventilation in cardiac patients has shown to be beneficial. Janus is a novel full-face mask that allows application of noninvasive ventilation support during anesthesia. Our main objective was to evaluate the feasibility of transcatheter aortic valve replacement with prolonged transesophageal echocardiographic monitoring under deep inhalational sedation delivered through a new mask for noninvasive ventilation.

Methods: A case series observational study that included five patients with critical aortic stenosis that underwent inhalational anesthesia with sevoflurane for transcatheter aortic valve replacement in a hybrid room of a teaching hospital. Standard monitors and bispectral index were used, followed by inhalational induction and placement of the Janus mask. Anesthesia was maintained with sevoflurane. Patients were transferred to intensive care unit after the procedure. Complications related to the mask use, transesofageal echocardiography accessibility and respiratory implications to the patients were recorded.

Results: All procedures were uneventful and no major complications were observed intraoperatively. One patient presented CO retention (50 mmHg) and sevoflurane leak around the central opening of the mask, both without clinical significance.

Conclusions: The use of inhalational anesthesia with the facial mask Janus is a safe and efficient alternative to general anesthesia with tracheal intubation for transcatheter aortic valve replacement and can easily accommodate the use of transesophageal echocardiography intraoperatively.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391787PMC
http://dx.doi.org/10.1016/j.bjan.2018.01.014DOI Listing

Publication Analysis

Top Keywords

aortic valve
16
valve replacement
16
transcatheter aortic
12
facial mask
8
aortic stenosis
8
tracheal intubation
8
noninvasive ventilation
8
inhalational anesthesia
8
mask
7
aortic
6

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!