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, 9 (4), e025825

Anaesthesia-related Complications and Side-Effects in TAVI: A Retrospective Study in Germany

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Anaesthesia-related Complications and Side-Effects in TAVI: A Retrospective Study in Germany

Sophia Goldfuss et al. BMJ Open.

Abstract

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.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Number of prophylactically administered postoperative nausea and vomiting (PONV) medications, depending on the patients’ PONV risk. All data are presented as n (number).
Figure 2
Figure 2
Incidence of postoperative nausea and vomiting (PONV), depending on the patient’s PONV risk: intraoperative prophylaxis versus no prophylaxis. 1: p=0.746; 2: p=0.34; 3: p=0.213; 4: p=0.055. All data are presented in per cent.
Figure 3
Figure 3
Length of stay (LOS) in the intensive care unit (ICU), intermediate care unit (IMC) and hospital for patients with delirium versus patients without delirium. ICU: p=0.054; IMC: p=0.002; hospital: p=0.035. All data are presented as mean ±SD.
Figure 4
Figure 4
Causes for non-extubation in the surgical room. All data are presented in per cent.

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