• Hirotsugu Miyoshi, Satoshi Kamiya, Tsuyoshi Ikeda, Soshi Narasaki, Takashi Kondo, Daiki Syourin, Ayako Sumii, Kenshiro Kido, Sachiko Otsuki, Takahiro Kato, Ryuji Nakamura, and Yasuo M Tsutsumi.
• Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. h-miyoshi@hiroshima-u.ac.jp.
• BMC Anesthesiol. 2024 Jun 21; 24 (1): 209209.

BackgroundWe used transcatheter aortic valve implantation (TAVI) procedure time to investigate the association between surgical team maturity and outcome.MethodsAmong patients who underwent TAVI between October 2015 and November 2019, those who had Sapien™ implanted with the transfemoral artery approach were included in the analysis. We used TAVI procedure time and surgery number to draw a learning curve. Then, we divided the patients into two groups before and after the number of cases where the sigmoid curve reaches a plateau. We compared the two groups regarding the surveyed factors and investigated the correlation between the TAVI procedure time and survey factors.ResultsNinety-nine of 149 patients were analysed. The sigmoid curve had an inflection point in 23.2 cases and reached a plateau in 43.0 cases. Patients in the Late group had a shorter operating time, less contrast media, less radiation exposure, and less myocardial escape enzymes than the Early group. Surgical procedure time showed the strongest correlation with the surgical case number.ConclusionThe number of cases required for surgeon proficiency for isolated Sapien™ valve implantation was 43. This number may serve as a guideline for switching the anesthesia management of TAVI from general to local anesthesia.© 2024. The Author(s).

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