Anesthetic considerations for transcatheter pulmonary valve replacement

The introduction of transcatheter therapy for valvular heart disease has revolutionized the care of patients with valvular disorders. Pathologic regurgitation or stenosis of the pulmonary valve, right ventricular outflow tract, or a right ventricle to pulmonary artery conduit represents an emerging...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2018-02, Vol.32 (1), p.402-411
Main Authors: Gregory, Stephen H., MD, Zoller, Jonathan K., MD, Shahanavaz, Shabana, MBBS, Chilson, Kelly L., MD, Ridley, Clare H., MD
Format: Article
Language:English
Subjects:
anesthesia
Anesthesia & Perioperative Care
cardiac surgical procedures
Critical Care
heart defects, congenital
pulmonary valve
pulmonic regurgitation
pulmonic stenosis
transcatheter valve replacement
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Summary:The introduction of transcatheter therapy for valvular heart disease has revolutionized the care of patients with valvular disorders. Pathologic regurgitation or stenosis of the pulmonary valve, right ventricular outflow tract, or a right ventricle to pulmonary artery conduit represents an emerging indication for transcatheter therapy. To date, minimal literature exists detailing the anesthetic management of patients undergoing transcatheter pulmonary valve replacement. In this review, we examine the pathophysiology and indications for TPVR as well as possible complications unique to this procedure. We then discuss anesthetic management, including preoperative assessment, intraoperative considerations, and early postoperative monitoring.
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2017.06.002