Monitored anesthesia care with dexmedetomidine in transfemoral percutaneous trans-catheter aortic valve implantation: two cases report.
Percutaneous trans-catheter aortic valve implantation (TAVI) is recommended for inoperable patients with severe aortic stenosis at high risk for conventional aortic valve replacement. Originally, TAVI was mostly performed under general anesthesia. Here we describe two cases of transfemoral TAVI performed under monitored anesthesia care (MAC) with dexmedetomidine. Dexmedetomidine provides sedation, analgesia with minimal respiratory depression. Although MAC during transfemoral TAVI has limitations, such as unexpected patient movement and difficulty in intra-procedural use of transesophageal echocardiography, MAC with dexmedetomidine is feasible with close monitoring, fluoroscopic guidance and the participation of experienced anesthesiologists.
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hee-Sun
HS
Park
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kyung-Mi
KM
Kim
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kyoung-Woon
KW
Joung
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
In-Cheol
IC
Choi
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ji-Yeon
JY
Sim
Anesthesia; Dexmedetomidine; Heart valve prosthesis implantation; Hypnotics and Sedatives