Objective: Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement and has become a popular treatment modality for inoperable or patients at high surgical risk with severe aortic stenosis. We aimed to evaluate our perioperative anaesthetic experiences with patients undergoing TAVI under sedation or general anaesthesia (GA).
Methods: One hundred and fifty-nine patients who underwent TAVI procedures were enrolled. Effects on TAVI outcomes of sedation and GA were compared.
Results: The duration of surgery and anaesthesia was significantly longer in patients who received GA. Insertion site complication and post-TAVI pacemaker implantation rates were similar between the groups, but the frequency of intraoperative complications (10% vs. 0.8%; =0.015), intraoperative hypotension (35.3% vs. 70%; < 0.001), and acute kidney injury (12.6% vs. 27.5%; =0.028) was significantly higher in the GA group. Stroke occurred in seven patients, and all were in the sedation group.
Conclusion: GA is related to increased procedure time and acute kidney injury; therefore, local anaesthesia and sedation may be the first option in patients undergoing TAVI.
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http://dx.doi.org/10.4274/TJAR.231270 | DOI Listing |
Int J Cardiovasc Imaging
January 2025
Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210st, Bronx, NY, USA.
Computed tomography (CT)-derived Epicardial Adipose Tissue (EAT) is linked to cardiovascular disease outcomes. However, its role in patients undergoing Transcatheter Aortic Valve Replacement (TAVR) and the interplay with aortic stenosis (AS) cardiac damage (CD) remains unexplored. We aim to investigate the relationship between EAT characteristics, AS CD, and all-cause mortality.
View Article and Find Full Text PDFCan J Cardiol
January 2025
Division of Cardiac Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB. Electronic address:
The volume of transcatheter aortic valve implantation (TAVI) for treatment of isolated aortic stenosis has far surpassed surgical aortic valve replacement (SAVR). There has been a consequent increase in TAVI explantation, now the fastest growing cardiac surgical procedure. Transcatheter heart valve explantation can be technically complex, with higher perioperative morbidity and mortality than routine SAVR or valve-in-valve TAVI.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
January 2025
Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
Objective: We present our experience with endovascular Bentall procedure (Endo-Bentall) using a modular valve conduit (Endo-Bentall) in high-risk patients with aortic root pathologies.
Methods: The physician constructed Endo-Bentall device is composed of a self-expanding transcatheter aortic valve (TAVR), aortic endovascular stent graft (TEVAR), and two wire-reinforced fenestrations for coronary artery stenting. The TAVR valve is sutured into an appropriately sized TEVAR graft.
J Thorac Cardiovasc Surg
January 2025
University of Maryland School of Medicine, Division of Cardiothoracic Surgery. Electronic address:
Objective: Over 30% of patients presenting with acute type A aortic dissection (ATAAD) are considered high - risk or inoperable. This study aims to investigate the early and mid-term outcomes of complex endovascular aortic repair of aortic root, ascending aorta, and aortic arch among patients with ATAAD.
Methods: From January 2018 to January 2023, 29 patients who were considered high risk for open operation underwent endovascular aortic repair.
J Thorac Cardiovasc Surg
January 2025
Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI; The Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor, MI. Electronic address:
Objective: To compare sex and racial differences in 180-day infection rates after coronary artery bypass grafting (CABG) and aortic valve replacement (AVR).
Methods: A Statewide Society of Thoracic Surgeons Adult Cardiac Surgery Database was linked to Medicare claims data to identify 8,887 beneficiaries undergoing CABG and AVR (surgical or transcatheter) between 2017 and 2021. The primary outcome was the incidence of 180-day infection.
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