Savvoulidis Panagiotis, Nadir M Adnan, Moody William E, Steeds Richard, Ludman Peter F, Bradley Joseph R, Singh Aldrin, Lawton Ewa, Doshi Sagar N
Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK.
Institute for Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Echo Res Pract. 2023 Sep 7;10(1):14. doi: 10.1186/s44156-023-00025-w.
Routine pre-discharge echocardiography (ECHO) is recommended post transcatheter aortic valve implantation (TAVI) as a baseline for future comparison. However, there is no clear guidance on the optimal timing of this study.
The purpose of this retrospective study was to investigate the safety and work-force efficiency of intraprocedural same-day ECHO versus next-day ECHO, following transfemoral TAVI.
In this retrospective study 100 consecutive patients who underwent intraprocedural ECHO only were compared with 100 consecutive patients undergoing both intraprocedural and routine next-day ECHO following elective transfemoral TAVI. All patients received the Sapien 3/Ultra transcatheter heart valve and were treated with a minimalist procedure with conscious sedation. The composite of in-hospital mortality, urgent ECHO and new tamponade after leaving the cath lab and before discharge was not different between the two groups (4 vs. 4%, P = 1). There was no paravalvular leak more than mild in any of the cases. Length of stay was similar (1 day).
Intraprocedural post-TAVI ECHO appears as safe as next day pre-discharge ECHO and obviates the need for a routine next day study, thereby reducing burden on echocardiography services and allows better utilisation of resources.
经导管主动脉瓣植入术（TAVI）后，建议进行常规出院前超声心动图检查（ECHO），作为未来比较的基线。然而，对于这项检查的最佳时机尚无明确指导。
这项回顾性研究的目的是调查经股动脉TAVI术后术中当日ECHO与次日ECHO的安全性和劳动力效率。
在这项回顾性研究中，将100例仅接受术中ECHO的连续患者与100例接受择期经股动脉TAVI术后术中及常规次日ECHO的连续患者进行比较。所有患者均接受Sapien 3/Ultra经导管心脏瓣膜，并采用有意识镇静的简化手术进行治疗。两组患者在住院死亡率、紧急ECHO以及离开导管室后出院前新出现的心包填塞的综合情况方面无差异（4%对4%，P = 1）。所有病例中均未出现超过轻度的瓣周漏。住院时间相似（1天）。
TAVI术后术中ECHO似乎与次日出院前ECHO一样安全，无需进行常规次日检查，从而减轻了超声心动图服务的负担，并能更好地利用资源。
