Objectives: This study was performed to analyse anaesthesia-related complications and side effects in patients undergoing transcatheter aortic valve implantation (TAVI) under general anaesthesia.
Design: Retrospective study.
Setting: The study was performed as a single-centre study in a hospital of tertiary care in Germany.
Participants: All 853 patients, who underwent TAVI at the Universitätsklinikum Regensburg between January 2009 and July 2015, were included. 52.5% were female patients.
Primary and secondary outcome measures: We gathered information, such as recent illness, vital parameters and medication administered during the intervention and postoperatively for 12 hours. We analysed all anaesthesia-related complications and anaesthesia-related side effects that occurred during the intervention and entire hospital stay.
Results: We analysed all 853 TAVI procedures. The mean patient age was 79 ± 6 years. In 99.5% of cases, we used volatile-based anaesthesia. 2.8% (n=24; transfemoral (TF): n=19 [3.8%]; transapical (TA): n=5 [1.4%]) of all cases suffered from anaesthesia-related complications. 819 (TF: n=447; TA: n=372) anaesthesia-related side effects occurred in 586 (68.7%, TF: n=325 [64.2%], TA: n=261 [75.2%]) patients. Neither the complications nor the side effects had any serious consequences. Intraoperative hypothermia in 44% of cases (TF: n=202 [39.9%]; TA: n=173 [49.9%]) and postoperative nausea and vomiting in 27% (n=232; TF: n=131 [25.9%], TA: n=101 [29.1%]) of cases were the most common anaesthesia-related side effects.
Conclusion: In this study, serious anaesthesia-related complications were rarely seen, and non-critical anaesthesia-related side effects could have been avoided through consistent prophylaxis and management. Therefore, despite their high anaesthetic risk, general anaesthesia is justifiable in patients who underwent TAVI.
Keywords: TAVI; complications; general anaesthesia; transapical; transfemoral.
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Conflict of interest statement
Competing interests: None declared.
Complications After Transcatheter Aortic Valve Implantation Using Transfemoral and Transapical Approach in General AnaesthesiaF Würschinger et al. PLoS One 13 (4), e0193558. PMID 29652895.In the present study, we showed that our patients' outcomes are comparable to those reported in the available literature. Compared to TF, TA patients show an overall wors …
A Meta-Analysis of Mortality and Major Adverse Cardiovascular and Cerebrovascular Events in Patients Undergoing Transfemoral Versus Transapical Transcatheter Aortic Valve Implantation Using Edwards Valve for Severe Aortic StenosisHB Panchal et al. Am J Cardiol 114 (12), 1882-90. PMID 25438917. - ReviewThe purpose of this meta-analysis was to compare 1 year mortality and major adverse cardiovascular and cerebrovascular events between transfemoral (TF) transcatheter aort …
Transfemoral, Transapical and Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement: A Meta-Analysis of Direct and Adjusted Indirect Comparisons of Early and Mid-Term DeathsT Ando et al. Interact Cardiovasc Thorac Surg 25 (3), 484-492. PMID 28549125. - ReviewClinical outcomes of transfemoral-transcatheter aortic valve implantation (TF-TAVI) versus surgical aortic valve replacement (SAVR) or transapical (TA)-TAVI are limited t …
Transapical Transcatheter Aortic Valve Implantation in Patients With a Low Ejection FractionG Imnadze et al. Interact Cardiovasc Thorac Surg 26 (2), 224-229. PMID 29049741.The data suggest that, for patients with a reduced EF, TA-TAVI is not associated with a poorer outcome compared with TF-TAVI. Therefore, TA access should not be discounte …
Transfemoral Versus Transapical Transcatheter Aortic Valve Implantation: A Single-Centre ExperienceW Reents et al. Eur J Cardiothorac Surg 55 (4), 744-750. PMID 30418538.The increased mortality of patients undergoing TA TAVI is associated with the patient risk profile and the institutional experience but not with the access mode itself. …
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