title: [Anesthetic management and experience in the transcatheter implantation of the CoreValve(®) self-expanding aortic valve].
abstract: OBJECTIVE
  To analyze the experience and anesthetic management in the transcatheter implantation of the CoreValve(®) self-expanding aortic valve, in a university tertiary hospital.
  
  
  METHODS
  Observational analytical review of data incorporated into a prospectively maintained database of 142 patients diagnosed with severe aortic stenosis who underwent implantation of a CoreValve(®) aortic self-expanding aortic valve between December 2007 and December 2012.
  
  
  RESULTS
  The mean age of patients was 82.5±6.1 years and the logistic EuroSCORE was 14.9±11.2. General anesthesia was used in 107 patients (75.3%), with local anesthesia with sedation in 35 (24.6%). Local anesthesia and sedation was associated with a lower requirement of vasoactive drugs (P=.003) during implantation. No statistically significant differences were found between the 2 anesthetic techniques in the duration of the procedure, hospital stay, or morbimortality. The success rate was 97.1%. The most common complication was conduction disorders that required implantation of a permanent pacemaker in 46 patients (32.3%). There was no intraoperative mortality, and all-cause mortality at 30 days was 6.3%, with a one-year survival estimated by the Kaplan-Meier of 83.1%.
  
  
  CONCLUSIONS
  This study confirms that in patients with severe aortic stenosis and high surgical risk, transcatheter implantation of aortic valve is a safe and effective alternative. Both, general anesthesia and local anesthesia with sedation are valid options, depending on the experience of the team.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Central de Asturias, Oviedo, España. Electronic address: felixezequiel@gmail.com.
authors.forename: F E
authors.initials: FE
authors.lastname: Fernández Suárez
authors.forename: R
authors.initials: R
authors.lastname: del Valle Fernández
authors.forename: A
authors.initials: A
authors.lastname: González Alvarez
authors.forename: J
authors.initials: J
authors.lastname: Sánchez Lasheras
authors.forename: L
authors.initials: L
authors.lastname: Fernández Sánchez
authors.forename: L
authors.initials: L
authors.lastname: Argüelles Tamargo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D000772:Anesthesia, Local; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D065467:Transcatheter Aortic Valve Replacement
keywords: Anestesia general; Anestesia local; Aortic valve; Atención perioperatoria; Cardiac catheterization; Cateterismo cardiaco; General anesthesia; Implantación de prótesis de válvula aórtica; Implantation of aortic valve prosthesis; Local anesthesia; Perioperative care; Válvula aórtica