Management of the Patient for Transcatheter Aortic Valve Implantation in the Perioperative Period

Aortic 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 implantatio...

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Bibliographic Details
Published in:Seminars in cardiothoracic and vascular anesthesia 2012-03, Vol.16 (1), p.25-40
Main Authors: Huffmyer, Julie, Tashjian, Jessica, Raphael, Jacob, Jaeger, J. Michael
Format: Article
Language:English
Subjects:
Acute Kidney Injury - etiology
Anesthesia
Animals
Aortic Valve - surgery
Aortic Valve Insufficiency - complications
Aortic Valve Stenosis - surgery
Blood Vessels - injuries
Cardiac Catheterization
Cardiac Surgical Procedures - methods
Echocardiography, Transesophageal
Heart Conduction System - physiopathology
Heart Valve Prosthesis Implantation - methods
Hemodynamics - physiology
Humans
Intraoperative Care
Minimally Invasive Surgical Procedures - methods
Pain, Postoperative - therapy
Perioperative Care
Perioperative Period
Postoperative Care
Postoperative Complications - therapy
Preoperative Care
Treatment Outcome
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Summary:Aortic 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.
ISSN:1089-2532
1940-5596
DOI:10.1177/1089253211434966