Anesthetic management of transcatheter aortic valve implantation.
Ann Card Anaesth
;
2012 Jan; 15(1): 54-63
Artigo
em Inglês
| IMSEAR
| ID: sea-139636
ABSTRACT
Transcatheter aortic valve implantation (TAVI) is an emergent technique for high-risk patients with aortic stenosis. TAVI poses significant challenges about its management because of the procedure itself and the population who undergo the implantation. Two devices are currently available and marketed in Europe and several other technologies are being developed. The retrograde transfemoral approach is the most popular procedure; nevertheless, it may not be feasible in patients with significant aortic or ileo-femoral arterial disease. Alternatives include a transaxillary approach, transapical approach, open surgical access to the retroperitoneal iliac artery and the ascending aorta. A complementary approach using both devices and alternative routes tailored to the anatomy and the comorbidities of the single patient is a main component for the successful implementation of a TAVI program. Anesthetic strategies vary in different centers. Local anesthesia or general anesthesia are both valid alternatives and can be applied according to the patient's characteristics and procedural instances. General anesthesia offers many advantages, mainly regarding the possibility of an early diagnosis and treatment of possible complications through the use of transesophageal echocardiography. However, after the initial experiences, many groups began to employ, routinely, sedation plus local anesthesia for TAVI, and their procedural and periprocedural success demonstrates that it is feasible. TAVI is burdened with potential important complications vascular injuries, arrhythmias, renal impairment, neurological complications, cardiac tamponade, prosthesis malpositioning and embolization and left main coronary artery occlusion. The aim of this work is to review the anesthetic management of TAVI based on the available literature.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Valva Aórtica
/
Cuidados Pós-Operatórios
/
Cuidados Pré-Operatórios
/
Humanos
/
Cateterismo Cardíaco
/
Ponte Cardiopulmonar
/
Ecocardiografia Transesofagiana
/
Implante de Prótese de Valva Cardíaca
/
Hemodinâmica
/
Anestesia
Tipo de estudo:
Estudo de rastreamento
Idioma:
Inglês
Revista:
Ann Card Anaesth
Ano de publicação:
2012
Tipo de documento:
Artigo
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