title: Predictors of Prolonged Hemodynamic Compromise After Valve Deployment During Transcatheter Aortic Valve Implantation.
abstract: OBJECTIVE
  To identify the risk factors of prolonged hemodynamic compromise caused by rapid pacing for valve deployment during transcatheter aortic valve implantation.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  Forty-seven patients with severe aortic stenosis who underwent transcatheter aortic valve implantation.
  
  
  METHODS
  The time after the end of rapid pacing until systolic arterial pressure and SvO2 recovery (systolic arterial pressure>90 mmHg and SvO2>65%) was defined as "the hemodynamic recovery time" and was measured from online anesthetic charts. The total study population was divided into 2 groups according to the recovery time (third quartile in all patients; 33 and 14 patients in the early and delayed recovery groups, respectively). Subsequently, the factors associated with prolonged hemodynamic compromise after rapid pacing for valve deployment were identified by univariate and multivariate analyses.
  
  
  RESULTS
  Multivariate analysis identified left ventricular end-diastolic diameter (odds ratio, 0.774; 95% confidence interval, 0.608-0.915) and SvO2 (odds ratio, 0.748; 95% confidence interval, 0.590-0.868) as independent factors associated with prolonged hemodynamic compromise after rapid pacing for valve deployment.
  
  
  CONCLUSIONS
  SvO2 and left ventricular end-diastolic diameter were found to be significant independent predictors of prolonged hemodynamic compromise immediately after rapid pacing for valve deployment during transcatheter aortic valve implantation.
authors.affiliation: Departments of Anesthesiology and Intensive Care Medicine. Electronic address: iritake@anes.med.osaka-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iritakenishi
authors.affiliation: Departments of Anesthesiology and Intensive Care Medicine.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kamibayashi
authors.affiliation: Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Torikai
authors.affiliation: Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kuratani
authors.affiliation: Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
authors.affiliation: Departments of Anesthesiology and Intensive Care Medicine.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000639:trends; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000639:trends; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: aortic stenosis; mixed venous oxygen saturation; rapid pacing; transcatheter aortic valve implantation