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接受经导管主动脉瓣置换术(TAVR)且有或无麻醉医生在场的患者的结局。

Outcome of patients undergoing TAVR with and without the attendance of an anesthesiologist.

作者信息

Konigstein Maayan, Ben-Shoshan Jeremy, Zahler David, Flint Nir, Margolis Gilad, Granot Yoav, Aviram Galit, Halkin Amir, Keren Gad, Banai Shmuel, Finkelstein Ariel

机构信息

Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

出版信息

Int J Cardiol. 2017 Aug 15;241:124-127. doi: 10.1016/j.ijcard.2017.01.154. Epub 2017 Feb 9.

Abstract

BACKGROUND

During the last few years there is a shift from performing Transcatheter Aortic Valve Replacement (TAVR) under general anesthesia towards conscious sedation and local anesthesia only. In the vast majority of centers, sedation is guided by a qualified anesthesiologist. In our center, all TAVR procedures are being performed under local anesthesia and mild sedation, however, since September 2014, a large portion of TAVR procedures are being performed under local anesthesia without the presence of an anesthesiologist. Here we compare 30days outcome of patients undergoing TAVR with and without the presence of anesthesiologist in the catheterization laboratory.

METHODS AND RESULTS

From September 2014 through April 2016, 324 patients (mean age 82.8±6) with severe symptomatic aortic stenosis were assigned to transfemoral TAVR with (150 patients) or without (174 patients) the attendance of an anesthesiologist. Baseline clinical and echocardiographic characteristics were similar between the groups. No difference in procedural and 30-day mortality, vascular complications, and major/life threatening bleeding were observed between the groups (p>0.1, for all).

CONCLUSIONS

The presence of an anesthesiologist in the catheterization laboratory during transfemoral TAVR procedures did not significantly change 30-day outcome.

摘要

背景

在过去几年中,经导管主动脉瓣置换术(TAVR)的实施方式已从全身麻醉转变为仅采用清醒镇静和局部麻醉。在绝大多数中心,镇静由合格的麻醉医生指导。在我们中心,所有TAVR手术均在局部麻醉和轻度镇静下进行,然而,自2014年9月以来,很大一部分TAVR手术是在没有麻醉医生在场的情况下在局部麻醉下进行的。在此,我们比较了导管室中有无麻醉医生参与的TAVR患者的30天结局。

方法与结果

从2014年9月至2016年4月,324例(平均年龄82.8±6岁)有严重症状性主动脉瓣狭窄的患者被分配接受经股动脉TAVR,其中150例患者有麻醉医生在场,174例患者无麻醉医生在场。两组间的基线临床和超声心动图特征相似。两组间在手术和30天死亡率、血管并发症以及严重/危及生命的出血方面均未观察到差异(所有p>0.1)。

结论

在经股动脉TAVR手术过程中,导管室中有麻醉医生在场并未显著改变30天结局。

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