Impact of rapid ventricular pacing during TAVI on microvascular tissue perfusion

Background Rapid ventricular pacing (RVP) is an established technique to temporarily reduce left ventricular output during transcatheter aortic valve implantation (TAVI). The purpose of this study was to evaluate the impact of RVP on microvascular tissue perfusion (MTP) in patients undergoing TAVI....

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Bibliographic Details
Published in:Clinical research in cardiology 2014-11, Vol.103 (11), p.902-911
Main Authors: Selle, Anna, Figulla, Hans R., Ferrari, Markus, Rademacher, Wilma, Goebel, Bjoern, Hamadanchi, Ali, Franz, Marcus, Schlueter, Andrea, Lehmann, Thomas, Lauten, Alexander
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - mortality
Aortic Valve Stenosis - surgery
Cardiac Pacing, Artificial - methods
Cardiology
Cohort Studies
Confidence Intervals
Echocardiography, Doppler
Female
Heart Valve Prosthesis
Hospital Mortality
Humans
Intraoperative Care - methods
Logistic Models
Male
Medicine
Medicine & Public Health
Microcirculation - physiology
Odds Ratio
Original Paper
Perfusion
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Analysis
Transcatheter Aortic Valve Replacement - methods
Transcatheter Aortic Valve Replacement - mortality
Treatment Outcome
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Summary:Background Rapid ventricular pacing (RVP) is an established technique to temporarily reduce left ventricular output during transcatheter aortic valve implantation (TAVI). The purpose of this study was to evaluate the impact of RVP on microvascular tissue perfusion (MTP) in patients undergoing TAVI. Methods and results We studied 42 patients (mean age 81.8 ± 6.9 years, n  = 18 females. EuroSCORE 33 ± 12 %) during TAVI. MTP was analyzed using Sidestream–Darkfield imaging, of the sublingual microvasculature. Microvascular flow index (MFI) was continuously measured in small (10–25 μm)- and medium (26–50 μm)-sized vessels, starting 10 s before and ending 12 s after RVP. Further, perfused capillary density, total vessel density and the proportion of perfused vessels were assessed. After a mean RVP duration of 14.3 s (range 6–29), mean arterial pressure decreased from 68 ± 05 to 40 ± 7 mmHg ( p  
ISSN:1861-0684
1861-0692
DOI:10.1007/s00392-014-0728-9