• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验

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.

DOI:10.1016/j.ijcard.2017.01.154
PMID:28215468
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。

相似文献

1
Outcome of patients undergoing TAVR with and without the attendance of an anesthesiologist.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。
Int J Cardiol. 2017 Aug 15;241:124-127. doi: 10.1016/j.ijcard.2017.01.154. Epub 2017 Feb 9.
2
Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement: Insights from the National Cardiovascular Data Registry Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.经导管主动脉瓣置换术的清醒镇静与全身麻醉:来自美国胸外科医师学会/美国心脏病学会经导管瓣膜治疗注册研究的国家心血管数据注册协会的观点。
Circulation. 2017 Nov 28;136(22):2132-2140. doi: 10.1161/CIRCULATIONAHA.116.026656. Epub 2017 Sep 1.
3
Routine minimalist transcatheter aortic valve implantation with local anesthesia only.仅在局部麻醉下进行常规微创经导管主动脉瓣植入术。
J Cardiovasc Med (Hagerstown). 2020 Oct;21(10):805-811. doi: 10.2459/JCM.0000000000001030.
4
Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement: Variation in Practice and Outcomes.经导管主动脉瓣置换术中的清醒镇静与全身麻醉:实践与结局的差异。
JACC Cardiovasc Interv. 2020 Jun 8;13(11):1277-1287. doi: 10.1016/j.jcin.2020.03.008.
5
Improved costs and outcomes with conscious sedation vs general anesthesia in TAVR patients: Time to wake up?经导管主动脉瓣置换术(TAVR)患者中,与全身麻醉相比,清醒镇静可改善成本和预后:是时候清醒了?
PLoS One. 2017 Apr 5;12(4):e0173777. doi: 10.1371/journal.pone.0173777. eCollection 2017.
6
Outcome After General Anesthesia Versus Monitored Anesthesia Care in Transfemoral Transcatheter Aortic Valve Replacement.经股动脉经导管主动脉瓣置换术全身麻醉与监护麻醉的效果比较
J Cardiothorac Vasc Anesth. 2016 Oct;30(5):1238-43. doi: 10.1053/j.jvca.2016.05.034. Epub 2016 May 21.
7
Standardized methodology for transfemoral transcatheter aortic valve replacement with the Edwards Sapien XT valve under fluoroscopy guidance.在荧光透视引导下使用爱德华兹Sapien XT瓣膜进行经股动脉经导管主动脉瓣置换术的标准化方法。
J Invasive Cardiol. 2014 Sep;26(9):451-61.
8
Safety of Conscious Sedation for Transcatheter Aortic Valve Replacement Without an Anesthetist.经导管主动脉瓣置换术无麻醉师行清醒镇静的安全性。
J Invasive Cardiol. 2021 Mar;33(3):E220-E224. Epub 2021 Feb 4.
9
Open Surgical Access for Transfemoral TAVR Should Not Be a Contraindication for Conscious Sedation.经股动脉经导管主动脉瓣置换术的开放手术入路不应成为清醒镇静的禁忌证。
J Cardiothorac Vasc Anesth. 2019 Jan;33(1):39-44. doi: 10.1053/j.jvca.2018.05.036. Epub 2018 May 26.
10
Critical adverse events during transfemoral TAVR in conscious sedation. Is an anesthesiologic support mandatory?清醒镇静下经股动脉经导管主动脉瓣置换术期间的严重不良事件。麻醉支持是必需的吗?
Cardiovasc Revasc Med. 2018 Sep;19(6S):41-46. doi: 10.1016/j.carrev.2018.06.014. Epub 2018 Jun 21.

引用本文的文献

1
Trends in transcatheter aortic valve implantation practice and clinical outcomes at an Irish tertiary referral centre.爱尔兰三级转诊中心经导管主动脉瓣植入术实践和临床结局的趋势。
Open Heart. 2024 Mar 27;11(1):e002610. doi: 10.1136/openhrt-2024-002610.
2
Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention.优化经导管主动脉瓣置换术中的麻醉选择:在疗效与最小干预之间达成微妙平衡
Cardiol Res Pract. 2024 Feb 29;2024:4217162. doi: 10.1155/2024/4217162. eCollection 2024.
3
Prophylactic Awake Peripheral V-A ECMO during TAVR.
经导管主动脉瓣置换术(TAVR)期间的预防性清醒外周静脉-动脉体外膜肺氧合(ECMO)
J Clin Med. 2023 Jan 20;12(3):859. doi: 10.3390/jcm12030859.
4
Comparison of Safety and Effectiveness of Local or General Anesthesia after Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis.经导管主动脉瓣植入术后局部麻醉与全身麻醉的安全性和有效性比较:一项系统评价和荟萃分析
J Clin Med. 2023 Jan 7;12(2):508. doi: 10.3390/jcm12020508.
5
Update on Minimalist TAVR Care Pathways: Approaches to Care in 2022.微创经导管主动脉瓣置换术(TAVR)治疗路径的最新进展:2022 年的治疗方法。
Curr Cardiol Rep. 2022 Sep;24(9):1179-1187. doi: 10.1007/s11886-022-01737-x. Epub 2022 Jun 29.
6
Is a designated arterial catheter indicated in transcatheter aortic valve replacement procedure?在经导管主动脉瓣置换手术中是否需要使用专用动脉导管?
J Biomed Res. 2022 Mar 28;36(2):73-76. doi: 10.7555/JBR.36.20220036.
7
Nurse-led sedation for transfemoral transcatheter aortic valve implantation seems safe for a selected patient population.对于特定患者群体,护士主导的经股动脉经导管主动脉瓣植入镇静似乎是安全的。
Eur Heart J Suppl. 2022 Mar 30;24(Suppl B):B23-B27. doi: 10.1093/eurheartjsupp/suac004. eCollection 2022 Apr.
8
Single-center experience of 105-minimalistc transfemoral transcatheter aortic valve replacement and its outcome.105 例微创经股动脉主动脉瓣置换术的单中心经验及其结果。
Indian Heart J. 2021 May-Jun;73(3):301-306. doi: 10.1016/j.ihj.2021.01.023. Epub 2021 Feb 3.
9
Update on Transcatheter Aortic Valve Replacement.经导管主动脉瓣置换术的最新进展
Cardiol Ther. 2020 Jun;9(1):75-84. doi: 10.1007/s40119-020-00167-6. Epub 2020 Feb 28.
10
Role of Echocardiography in Transcatheter Valvular Heart Disease Interventions.超声心动图在经导管瓣膜心脏病介入治疗中的作用。
Curr Cardiol Rep. 2017 Oct 27;19(12):128. doi: 10.1007/s11886-017-0942-y.