Ana Margarida Martins, Maria de Lurdes Castro, Isabel Fragata
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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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"26 1","pages":"37-44"},"PeriodicalIF":0.0000,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Correlation between anesthetic decision and clinical characteristics and results in patients submitted to TAVI].\",\"authors\":\"Ana Margarida Martins, Maria de Lurdes Castro, Isabel Fragata\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":87136,\"journal\":{\"name\":\"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular\",\"volume\":\"26 1\",\"pages\":\"37-44\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨影响TAVI患者术前麻醉技术选择的因素。对本院的手术结果进行了评价。方法:对2010年1月至2016年12月在Santa Marta医院接受TAVI治疗的患者进行回顾性研究。数据收集于术中记录,并根据麻醉技术分层。围手术期并发症的定义参照The Valve Academic Research Consortium 2。术前决定麻醉方式选择的因素通过卡方检验(分类变量)和学生t检验(连续变量)确定,然后进行逻辑回归。结果:TC检测血管通路不良是术前选择全麻的决定因素。动脉高血压和既往急性心肌梗死是选择局麻加镇静的决定因素。149例患者中,105例(70.5%)出现术后并发症;最常见的是心律失常(n=53;35.6%),大出血(n=50;33.6%)和血管并发症(n=36;24日,2%)。结论:对于TAVI患者的最佳麻醉技术尚未达成共识。这是麻醉师决定最合适的麻醉技术选择,考虑技术方面和客观评价的病人。局部麻醉加镇静有一些优点:手术时间短,需要使用血管加压药物的病人少。TAVI是一个高度复杂的程序,多学科方法是其成功的基础。
[Correlation between anesthetic decision and clinical characteristics and results in patients submitted to TAVI].
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.