Document Detail


Transfemoral aortic valve implantation under sedation and monitored anaesthetic care - a feasibility study.
MedLine Citation:
PMID:  21933156     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Surgical aortic valve replacement is the conventional treatment for symptomatic aortic valve stenosis; however, the technique of transfemoral transcatheter aortic valve implantation has recently been developed for older patients at high risk for surgery. We assessed whether this procedure could be safely performed under sedation in 100 patients. Their predicted surgical mortality was 21.6% and mean (SD) age 80 (6.6) years. Sedation was provided by remifentanil infusion (0-0.2 μg.kg(-1) .min(-1) ) and midazolam (1-3 mg), as required. All patients were closely haemodynamically monitored throughout by an anaesthetist and inotropic drugs administered as indicated by invasive monitoring. Sedation alone was required in 83 patients; in 17 patients sedation had to be converted to general anaesthesia, mainly because of interventional complications (n = 12). All conversions to general anaesthesia occurred after successful valve implantation. Mean (SD) anaesthesia time was 31 (12) min and procedural time 107 (77) min; 30-day and 1-year all-cause mortality were 6% and 13%, respectively. In the majority of patients, transcatheter valve implantation can safely be facilitated by sedation, provided monitoring and drug administration are carried out by an experienced cardiac anaesthetist. You can respond to this article at http://www.anaesthesiacorrespondence.com.
Authors:
L Bergmann; P Kahlert; H Eggebrecht; U Frey; J Peters; E Kottenberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-20
Journal Detail:
Title:  Anaesthesia     Volume:  -     ISSN:  1365-2044     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Affiliation:
 Staff Anaesthetist  Professor of Anaesthesia and Intensive Care Medicine, and Chairman, Klinik für Anästhesiolgie und Intensivmedizin  Staff Cardiologist, Klinik für Kardiologie, Universität Duisburg-Essen, Universitütsklinikum Essen, Essen, Germany.
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