Horn Patrick, Hellhammer Katharina, Minier Michael, Stenzel Monika A, Veulemans Verena, Rassaf Tienush, Luedike Peter, Pohl Julia, Balzer Jan, Zeus Tobias, Kelm Malte, Westenfeld Ralf
Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany.
Catheter Cardiovasc Interv. 2017 Dec 1;90(7):1212-1219. doi: 10.1002/ccd.26884. Epub 2017 Jan 23.
To investigate in a series of 232 patients whether the MitraClip procedure can be performed safely using deep sedation (DS) without general anesthesia (GA).
Transcatheter mitral valve repair using the MitraClip system is a safe and effective therapy for severe mitral regurgitation (MR) in patients who are at high operative risk or are unsuitable for surgery. For these patients, avoidance of GA might be beneficial.
Between 2011 and 2015, we performed 232 MitraClip procedures for the treatment of severe MR. Of those, 76 procedures were performed using GA, while the remaining 156 procedures were performed using DS.
Age, logistic EuroScore, severity of MR, left and right ventricular function, and renal function did not differ between the groups. The primary combined safety endpoint, which was defined as the occurrence of major adverse cardiac and cerebrovascular events, conversion to surgery, major vascular complications or pneumonia, did not differ between MitraClip procedures performed using GA and MitraClip procedures performed using DS. Intraprocedural conversion to GA was required in 2% of the patients in the DS group. There were no differences in procedural success or clinical outcome between the groups at the 3-month follow-up. Preparation time in the catheterization laboratory and intensive care unit (ICU) stay were shorter in the DS group compared to the GA group.
The MitraClip implantation performed using DS is as safe and effective as MitraClip implantation performed using GA. © 2017 Wiley Periodicals, Inc.
在232例患者中研究使用深度镇静（DS）而非全身麻醉（GA）进行MitraClip手术是否安全。
使用MitraClip系统进行经导管二尖瓣修复对于手术风险高或不适合手术的严重二尖瓣反流（MR）患者是一种安全有效的治疗方法。对于这些患者，避免全身麻醉可能有益。
2011年至2015年间，我们进行了232例MitraClip手术以治疗严重MR。其中，76例手术使用全身麻醉，其余156例手术使用深度镇静。
两组患者的年龄、逻辑欧洲心脏手术风险评估系统（EuroScore）、二尖瓣反流严重程度、左心室和右心室功能以及肾功能无差异。主要联合安全终点定义为发生重大不良心脑血管事件、转为手术、重大血管并发症或肺炎，使用全身麻醉进行的MitraClip手术和使用深度镇静进行的MitraClip手术之间无差异。深度镇静组2%的患者术中需要转为全身麻醉。两组在3个月随访时手术成功率或临床结局无差异。与全身麻醉组相比，深度镇静组在导管室的准备时间和重症监护病房（ICU）住院时间更短。
使用深度镇静进行的MitraClip植入与使用全身麻醉进行的MitraClip植入一样安全有效。©2017威利期刊公司。
