[Correlation between anesthetic decision and clinical characteristics and results in patients submitted to TAVI].

Abstract

Objective: The preoperative factors determining the selection of anesthetic technique in patients submitted to TAVI were identified. The results of this procedure in our hospital were evaluated.

Methods: Retrospective study in patients submitted to TAVI in Santa Marta Hospital (January 2010 to December 2016). Data collected from periprocedural records and stratified according to the anesthetic technique. Periprocedural complications were defined according to The Valve Academic Research Consortium 2. The preoperative factors determining the selection of anesthetic technique were identified through Chi-square test (categorical variables) and Student's t tests (continuous variables), followed by logistic regression.

Results: Bad vascular access identified by TC was a preoperative determinant for general anesthesia selection. Arterial hypertension and previous acute myocardial infarction were determinants for selection of local anesthesia with sedation. From a total of 149 patients, 105 (70,5%) developed some postprocedural complication; the most common were arrhythmias (n=53; 35,6%), major bleeding (n=50; 33,6%) and vascular complications (n=36; 24,2%).

Conclusion: There is no consensus regarding the best anesthetic technique to be performed in patients submitted to TAVI. It is the anesthesiologist decision which most appropriate anesthetic technique to select, considering technical aspects and objective evaluation of the patient. Local anesthesia with sedation showed some advantages: shorter duration of procedure and fewer patients requiring vasopressor drugs administration. TAVI is a highly complex procedure and a multidisciplinary approach is fundamental to its success.