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Semin Cardiothorac Vasc Anesth · Mar 2012
ReviewManagement of the patient for transcatheter aortic valve implantation in the perioperative period.
- Julie Huffmyer, Jessica Tashjian, Jacob Raphael, and J Michael Jaeger.
- University of Virginia, Charlottesville, VA 22908-0710, USA. jh3wd@virginia.edu
- Semin Cardiothorac Vasc Anesth. 2012 Mar 1;16(1):25-40.
AbstractAortic stenosis is a prevalent valvular disease among aging patients, and surgical correction is the most definitive treatment. Yet many elderly patients are deemed to be "inoperable" or at excessive risk to undergo open surgical aortic valve replacement (AVR). Transcatheter aortic valve implantation (TAVI), either through a transfemoral or transapical approach, has become a potential option for these high-risk patients. Although TAVI technology will continue to be developed and perfected, most studies at this time reveal that symptoms are improved and that 1-year morbidity and mortality are similar to those for open surgical AVR. Anesthetic management for patients undergoing TAVI involves maintaining hemodynamic stability during periods of rapidly changing conditions and providing echocardiographic guidance and assessment. Postoperative care includes a variety of challenges such as managing pain control, monitoring for potential complications, and providing hemodynamic management.
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