title: Anesthetic management of patients undergoing transcatheter aortic valve implantation.
abstract: OBJECTIVE
  To compare 2 anesthetic techniques, general anesthesia or monitored anesthesia care, performed by the same cardiac anesthesiologists for transcatheter aortic valve implantation in the authors' institution.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  A single specialized cardiac surgery center.
  
  
  METHODS
  Ninety-eight patients with severe aortic valve stenosis and a high logistic EuroSCORE considered not eligible to undergo conventional aortic valve replacement.
  
  
  METHODS
  General anesthesia or monitored anesthesia care.
  
  
  RESULTS
  General anesthesia was used in 57 and monitored anesthesia care in 41 patients. The authors compared the following parameters: Duration of procedure, transfusion requirements, cardiac indices, superior vena cava saturation (ScVO2) before and after the aortic valve implantation, hospital length of stay and 30-day mortality. The only significant differences between the groups concerned were the duration of anesthesia (p<0.001) and ScVO2 values. Anesthesia duration was prolonged significantly when general anesthesia was administered, and ScVO2 was significantly higher both before and after the valve implantation in the general anesthesia group. Thirty-day mortality was 5.3% in the general anesthesia group and 4.9% in the monitored anesthesia group.
  
  
  CONCLUSIONS
  It would appear that both anesthetic techniques may be used for patients with a high logistic EuroSCORE undergoing transcatheter aortic valve implantation.
authors: Department of Anesthesiology, Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: mbalanika@gmail.com.
authors: Marina
authors: M
authors: Balanika
authors: Department of Anesthesiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Anna
authors: A
authors: Smyrli
authors: Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.
authors: George
authors: G
authors: Samanidis
authors: Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Kostantinos
authors: K
authors: Spargias
authors: Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.
authors: George
authors: G
authors: Stavridis
authors: Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: George
authors: G
authors: Karavolias
authors: Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Mazen
authors: M
authors: Khoury
authors: Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Vasilios
authors: V
authors: Voudris
authors: Department of Anesthesiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Stavroula
authors: S
authors: Lacoumenta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery; D001366:Axillary Artery; D001803:Blood Transfusion; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005263:Femoral Artery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D016343:Monitoring, Intraoperative; D010100:Oxygen / Q000097:blood; D019990:Perioperative Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D016277:Ventricular Function, Left
chemical_list: D010975:Platelet Aggregation Inhibitors; D010100:Oxygen
keywords: anesthetic technique; aortic valve stenosis; transcatheter aortic valve implantation