dc.contributor | Montes Romero, Félix Ramón | |
dc.contributor | Durán-Torres, Felipe | |
dc.creator | Hurtado Peña, Pedro Arturo | |
dc.date.accessioned | 2020-08-04T16:57:17Z | |
dc.date.accessioned | 2022-09-22T14:24:58Z | |
dc.date.available | 2020-08-04T16:57:17Z | |
dc.date.available | 2022-09-22T14:24:58Z | |
dc.date.created | 2020-08-04T16:57:17Z | |
dc.identifier | https://repository.urosario.edu.co/handle/10336/25838 | |
dc.identifier | https://doi.org/10.48713/10336_25838 | |
dc.identifier.uri | http://repositorioslatinoamericanos.uchile.cl/handle/2250/3438569 | |
dc.description.abstract | Introduction: Transcatheter aortic valve implantation (TAVI) is recommended in patients with severe symptomatic aortic stenosis with prohibitive and high surgical risk. It is also an alternative in patients with intermediate surgical risk. Despite the growth in the number of TAVI procedures performed, the optimal anesthetic management has not been established. At our institution, TAVI was conventionally performed under general anesthesia (GA), yet in December 2017, a sedation management protocol was implemented. The objective of this study was to compare postinterventional outcomes of sedation with those of GA in patients undergoing transfemoral TAVI. Methods: This was a single-center, retrospective, before-after study. All consecutive patients who underwent transfemoral TAVI from January 2016 through March 2020 were stratified into two groups according to whether they received GA (before December 2017) or sedation (after December 2017) during the procedure. The primary endpoints were intensive care unit (ICU) and post-procedural hospital length of stays (LOS). Secondary endpoints were registered according to the Valve Academic Research Consortium-2 (VARC-2) criteria. In addition, the incidence of vasopressor use, procedural time, and anesthesia time was recorded. Data were analyzed by unpaired t-test with Welch´s correction, Fisher´s exact test or Chi-square as appropriate. P < 0.05 was considered statistically significant. Results: A total of 158 patients (53% male, mean age 79 years) underwent transfemoral TAVI under sedation (n = 82) or GA (n =76). Baseline characteristics are shown in Table 1. Seven patients (8.5%) in the sedation group required conversion to GA. Administration of sedation was associated with a significant decrease in UCI (1.7 vs 2.4 days, p = 0.002) and post-procedural hospital (3.4 vs 4.4 days, p = 0.009) LOS (Figure 1). The sedation group had a significantly shorter anesthesia time and less vasopressor requirement. Procedural time and VARC-2 endpoints were not significantly different (Table 1). Conclusions: Implementation of a sedation protocol for patients undergoing transfemoral TAVI was associated with improved ICU and hospital LOS. The incidence of important clinical endpoints was not affected by the anesthesia technique. | |
dc.language | spa | |
dc.publisher | Universidad del Rosario | |
dc.publisher | Especialización en Anestesia Cardiotorácica | |
dc.publisher | Facultad de Medicina | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.rights | Abierto (Texto Completo) | |
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POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos. | |
dc.source | Guarracino F, Baldassarri R. The Anesthetic Management of Transcatheter Aortic Valve Implantation. Semin Cardiothorac Vasc Anesth. 2015;20(2):141–6. | |
dc.source | Leon MB, Piazza N, Nikolsky E, Blackstone EH, Cutlip DE, Kappetein AP, et al. Standardized Endpoint Definitions for Transcatheter Aortic Valve Implantation Clinical Trials. J Am Coll Cardiol [Internet]. 2011;57(3):253–69. Available from: http://dx.doi.org/10.1016/j.jacc.2010.12.005 | |
dc.source | Eskandari M, Aldalati O, Dworakowski R, Byrne JA, Alcock E, Wendler O, et al. Comparison of general anaesthesia and non-general anaesthesia approach in transfemoral transcatheter aortic valve implantation. Heart. 2018;104(19):1621–8. | |
dc.source | Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Vol. 38, European Heart Journal. 2017. 2739–2786 p | |
dc.source | Dager AE, Nuis RJ, Caicedo B, Fonseca JA, Arana C, Cruz LRN, et al. Colombian experience with transcatheter aortic valve implantation of medtronic corevalve. Texas Hear Inst J. 2012;39(3):351–8 | |
dc.source | Figulla HR, Franz M, Lauten A. The history of Transcatheter Aortic Valve Implantation (TAVI)—A personal view over 25 years of development. Cardiovasc Revascularization Med [Internet]. 2019;(xxxx). Available from: https://doi.org/10.1016/j.carrev.2019.05.024 | |
dc.source | Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: First human case description. Circulation. 2002;106(24):3006–8. | |
dc.source | Brecker SJD, Bleiziffer S, Bosmans J, Gerckens U, Tamburino C, Wenaweser P, et al. Impact of Anesthesia Type on Outcomes of Transcatheter Aortic Valve Implantation (from the Multicenter ADVANCE Study). Am J Cardiol [Internet]. 2016;117(8):1332–8. Available from: http://dx.doi.org/10.1016/j.amjcard.2016.01.027 | |
dc.source | Villablanca PA, Mohananey D, Nikolic K, Bangalore S, Slovut DP, Mathew V, et al. Comparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta-analysis. Catheter Cardiovasc Interv [Internet]. 2018 Feb 1;91(2):330–42. Available from: http://doi.wiley.com/10.1002/ccd.27207 | |
dc.source | Svensson LG, Ph D, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, et al. Smith CR, Leon MB, Marck MJ, et al. Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients. N Engl J Med. 2011;364(364):2187–98. | |
dc.source | Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Vol. 135, Circulation. 2017. 1159–1195 p. | |
dc.source | Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374(17):1609–20. | |
dc.source | Linke A, Wenaweser P, Gerckens U, Tamburino C, Bosmans J, Bleiziffer S, et al. Treatment of aortic stenosis with a self-expanding transcatheter valve: The International Multi-centre ADVANCE Study. Eur Heart J. 2014;35(38):2672–84. | |
dc.source | Miles LF, Joshi KR, Ogilvie EH, Densem CG, Klein AA, O’Sullivan M, et al. General anaesthesia vs. Conscious sedation for transfemoral aortic valve implantation: A single UK centre before-and-after study. Anaesthesia. 2016;71(8):892–900. | |
dc.source | Mayr NP, Wiesner G, van der Starre P, Hapfelmeier A, Goppel G, Kasel AM, et al. Dexmedetomidine versus propofol-opioid for sedation in transcatheter aortic valve implantation patients: a retrospective analysis of periprocedural gas exchange and hemodynamic support. Can J Anesth [Internet]. 2018;65(6):647–57. Available from: https://doi.org/10.1007/s12630-018-1092-4 | |
dc.source | Stragier H, Dubois C, Verbrugghe P, Jacobs S, Adriaenssens T, Rex S. General Anesthesia Versus Monitored Anesthesia Care for Transfemoral Transcatheter Aortic Valve Implantation: A Retrospective Study in a Single Belgian Referral Center. Journal of Cardiothoracic and Vascular Anesthesia. 2019;33(12):3283-3291. | |
dc.source | Jabbar A, Khurana A, Mohammed A, Das R, Zaman A, Edwards R. Local Versus General Anesthesia in Transcatheter Aortic Valve Replacement. Am J Cardiol [Internet]. 2016;118(11):1712–6. Available from: http://dx.doi.org/10.1016/j.amjcard.2016.08.051 | |
dc.source | Fröhlich GM, Lansky AJ, Webb J, Roffi M, Toggweiler S, Reinthaler M, et al. Local versus general anesthesia for transcatheter aortic valve implantation (TAVR) -systematic review and meta-analysis. BMC Med. 2014;12(1):1–9. | |
dc.source | Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J [Internet]. 2018 Sep 1;39(33):3021–104. Available from: http://journals.lww.com/00004872-200706000-00001 | |
dc.source | Aldecoa C, Bettelli G, Bilotta F, Sanders RD, Audisio R, Borozdina A, et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017;34(4):192–214. | |
dc.source | Mason SE, Noel-Storr A, Ritchie CW. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: A systematic review with meta-analysis. J Alzheimer’s Dis. 2010;22(SUPPL. 3). | |
dc.source | Eskandari M, Aldalati O, Dworakowski R, et al. Comparison of general anaesthesia and non-general anaesthesia approach in transfemoral transcatheter aortic valve implantation. Heart. 2018;104(19):1621-1628. doi:10.1136/heartjnl-2017-312559 | |
dc.source | instname:Universidad del Rosario | |
dc.source | reponame:Repositorio Institucional EdocUR | |
dc.subject | Anestesia general | |
dc.subject | Sedación | |
dc.subject | TAVI | |
dc.subject | Transfemoral | |
dc.title | Anestesia general versus sedación para implante transcatéter de válvula aórtica: estudio retrospectivo en Hospital Colombiano | |
dc.type | masterThesis | |