Primary Report of Anesthesia Methods and Comorbidities in Patients Undergoing Transcatheter Aortic Valve Implementation (TAVI): An Observational Study

Maryam  Baniani; Ali  Dabbagh

doi:10.18502/aacc.v11i5.19918

Maryam Baniani Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Dabbagh Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v11i5.19918

Keywords: Elderly patients; Cardiovascular disease; Minimally invasive procedures; General anesthesia; Sedation; Safety

Abstract

Background: Transcatheter aortic valve implantation (TAVI) stands for a significant advancement in the treatment of patients suffering from aortic valve stenosis (AS). TAVI offers a significantly less invasive approach for aortic valve replacement compared to traditional thoracic surgery. Nonetheless, the anesthesiology component of TAVI remains underexplored. Consequently, our objective in this paper has been to explore this matter.

Methods: This trial is a unicenter observational study involving 32 patients undergoing TAVI with two methods of anesthesia, including general anesthesia and sedation. The study was conducted at Imam Hossein Hospital. The primary goal was to compare anesthesia methods regarding cardiac arrest and mortality, stroke, and thromboembolic events.

Results: This study included a total of 32 patients. 84.4% of the patients were male, while 15.6% were female. The average age of the patients participating in this study was 80.06±6.0 years. The most common comorbidities included hypertension, ischemic heart disease, diabetes, and hyperlipidemia, with prevalence rates of 62.5%, 56.3%, 46.9%, and 46.9%, respectively. 78.1% of patients underwent TAVI solely due to AS, whereas 21.9% underwent TAVI for AS together with other cardiovascular diseases. Nearly half of the patients, 46.9%, underwent general anesthesia, and 53.1% received sedation. 12.5% of patients experienced side effects following the procedure, which included atrial fibrillation rhythm, left bundle branch block, atheroembolism, and cardiac arrest. The occurrence of cardiac arrest was recorded at 3.1%.

Conclusion: This key report illustrates the safety of TAVI along with various anesthesia techniques, such as general anesthesia and sedation. General anesthesia was associated with more side effects than sedation. Nonetheless, further research is essential to establish the causal relationships between variables, side effects, and mortality.