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Title: | Transcutaneous aortic valve replacement with the Edwards SAPIEN XT and Medtronic CoreValve prosthesis under fluoroscopic guidance and local anaesthesia only |
Authors: | Greif, Martin Lange, Philipp Näbauer, Michael Schwarz, Florian Becker, Christoph Schmitz, Christoph Pohl, Tilmann D'Anastasi, Melvin Boekstegers, Peter Massberg, Steffen Kupatt, Christian |
Keywords: | Aortic valve -- Stenosis Heart valves -- Transplantation Heart valve prosthesis Aortic valve -- Surgery |
Issue Date: | 2014 |
Publisher: | BMJ Group |
Citation: | Greif, M., Lange, P., Näbauer, M., Schwarz, F., Becker, C., Schmitz, C.,...Kupatt, C. (2014). Transcutaneous aortic valve replacement with the Edwards SAPIEN XT and Medtronic CoreValve prosthesis under fluoroscopic guidance and local anaesthesia only. Heart, 100(9), 691-695. |
Abstract: | Objective To assess the feasibility of transcatheter
aortic valve implantation (TAVI; Medtronic CoreValve and
Edwards SAPIEN XT) under local anaesthesia with only
mild analgesic medication and fluoroscopic guidance.
Methods 461 patients underwent TAVI under local
anaesthesia with lidocaine. The procedure was
performed successfully in 459 of the cases. All patients
were also treated with piritramide, metoclopramide
hydrochloride and 62 mg dimenhydrinate. Monitoring
consisted of a six-electrode, virtual 12-lead ECG, pulse
oximetry, and invasive arterial pressure measurement.
There was no continuous surveillance by an
anaesthesiologist. Results There was no need for conversion to general anaesthesia except in four patients who required cardiopulmonary resuscitation. Conscious sedation with intravenous administration of midazolam for agitation or inotropic medication for prolonged hypotension was necessary in only seven of the 461 patients. The combined safety end point according to the Valve Academic Research Consortium consensus document was reached in 12.6%. Conclusions Our results show that TAVI performed under local anaesthesia with only mild analgesic medication and under fluoroscopic guidance is feasible, with good outcome comparable to published data. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/93228 |
Appears in Collections: | Scholarly Works - FacM&SCRNM |
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