Stolte Thorald, Sathananthan Janarthanan, Reichl Jakob Johannes, Boeddinghaus Jasper, Wagener Max, Schöpflin Christian, Kaiser Christoph, Leibundgut Gregor, Mahfoud Felix, Wood David, Webb John G, Nestelberger Thomas
Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, 4031 Basel, Switzerland.
Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
J Clin Med. 2025 May 28;14(11):3794. doi: 10.3390/jcm14113794.
Aortic valve stenosis (AS) is a prevalent cardiovascular condition among elderly patients frequently treated with Transcatheter Aortic Valve Implantation (TAVI). Traditional hemodynamic monitoring during TAVI relies on invasive methods. The ClearSight Finger Cuff system offers a non-invasive alternative for continuous hemodynamic monitoring. To compare the reliability and feasibility of non-invasive hemodynamic monitoring with traditional invasive hemodynamic monitoring during TAVI procedures. In this prospective observational study, patients undergoing elective TAVI were recruited from two tertiary hospitals between March and August 2023. Invasive hemodynamic measurements were obtained using arterial and pigtail catheters, with a subset undergoing right heart catheterization. Non-invasive measurements were captured using the ClearSight system. Data on baseline characteristics, procedural details, and 30-day follow-up outcomes were collected. The study cohort comprised 50 patients (median age 82 years (IQR 78.0, 85.8), 50% female). Non-invasive measurements of cardiac output (CO), cardiac index (CI), and stroke volume (SV) were consistently lower than invasive measurements (CO: 4.1 vs. 4.8 L/min, = 0.03; CI: 2.2 vs. 2.7 L/min/m, = 0.01, SV: 66 vs. 77 mL, = 0.25). Non-invasive blood pressure readings were lower than invasive radial and aortic measurements before and after TAVI. Correlation of non- and invasive measurements was low but similar before and after TAVI (Mean percentage error of 52%). The ClearSight system provided lower absolute values for all evaluated hemodynamic parameters as well as low correlation compared to traditional methods pre- as well as post-interventional.
主动脉瓣狭窄（AS）是老年患者中常见的心血管疾病，经导管主动脉瓣植入术（TAVI）是其常用治疗方法。TAVI 术中传统的血流动力学监测依赖于侵入性方法。ClearSight 指套式无创连续心排量监测系统提供了一种无创的连续血流动力学监测替代方法。本研究旨在比较 TAVI 手术中无创血流动力学监测与传统有创血流动力学监测的可靠性和可行性。在这项前瞻性观察性研究中，2023 年 3 月至 8 月期间从两家三级医院招募了接受择期 TAVI 的患者。使用动脉导管和猪尾导管进行有创血流动力学测量，部分患者还进行了右心导管检查。使用 ClearSight 系统进行无创测量。收集了患者的基线特征、手术细节和 30 天随访结果。研究队列包括 50 名患者（中位年龄 82 岁（四分位间距 78.0，85.8），50%为女性）。无创测量的心输出量（CO）、心脏指数（CI）和每搏输出量（SV）始终低于有创测量值（CO：4.1 与 4.8 L/分钟，P = 0.03；CI：2.2 与 2.7 L/分钟/平方米，P = 0.01，SV：66 与 77 毫升，P = 0.25）。TAVI 前后，无创血压读数均低于有创桡动脉和主动脉测量值。无创和有创测量之间的相关性较低，但 TAVI 前后相似（平均百分比误差为 52%）。与传统方法相比，ClearSight 系统在介入前后提供的所有评估血流动力学参数的绝对值均较低，且相关性也较低。
