Department of Anesthesiology, Hippokration Hospital, Athens, Greece.
1st Department of Cardiology, Medical School, University of Athens, Hippokration Hospital, Athens, Greece.
Hellenic J Cardiol. 2016 Nov-Dec;57(6):401-406. doi: 10.1016/j.hjc.2016.10.001. Epub 2016 Oct 6.
Transcatheter aortic valve implantation (TAVI) has become the mainstay for high-risk or inoperable patients with symptomatic aortic valve stenosis, and research regarding the use of transcatheter valves in intermediate or low-risk patients is currently ongoing. The aim of this article is to provide comprehensive insight into the anesthetic management of patients undergoing TAVI and to highlight possible gaps in the current knowledge. One important procedural characteristic that is imperative to consider is the type of anesthesia being used and its possible complications. Increasingly, experienced centers have changed from general anesthesia with endotracheal intubation to local anesthesia with sedation, especially when the transfemoral access route is used for TAVI. There is still debate regarding what type of anesthesia should be used in the procedure, and the lack of randomized data makes it even more challenging for the operators.
经导管主动脉瓣植入术（TAVI）已成为有症状的主动脉瓣狭窄高危或手术禁忌患者的主要治疗方法，目前正在研究经导管瓣膜在中危或低危患者中的应用。本文旨在提供对 TAVI 患者麻醉管理的全面了解，并强调当前知识中的可能差距。一个需要考虑的重要程序特征是所使用的麻醉类型及其可能的并发症。越来越多的有经验的中心已经从全身麻醉加气管插管改为局部麻醉加镇静，尤其是当经股动脉入路用于 TAVI 时。对于应该使用哪种类型的麻醉仍存在争议，而且缺乏随机数据使得这对操作者来说更具挑战性。
