title: Our Anaesthetic Experiences in Patients Undergoing Percutaneous Mitraclip Implantation.
abstract: OBJECTIVE
  Percutaneous mitraclip implantation system, is a new technique developed for patients with high surgical risks. It is generally performed in a catheterisation laboratory with the guidance of fluoroscopy and transesophageal echocardiography. In this study, we aimed to share our experiences on anaesthetic in patients undergoing mitraclip implantation under general anaesthesia.
  
  
  METHODS
  Eighty four patients with severe, symptomatic mitral insufficiency, who had undergone MitraClip implantation under general anaesthesia between July 2012 and March 2015 (54 male, 30 female; mean age: 68.5±10.2 years) were retrospectively investigated in terms of anaesthetic management.
  
  
  RESULTS
  Of the 84 patients undergoing percutaneous mitraclip implantation under general anaesthesia, 84.5% had sodium thiopental and 75% had midazolam for anaesthesia induction. For the maintenance of anaesthesia, 57% of the patients were reported to have sevoflurane, whereas the rest had desflurane. The mean duration of the procedure and anaesthesia was 140.9±48.2 mins and 165.7±50.6 min, respectively. Seventy seven patients were transported to the intensive care unit and intubated after the procedure. The median extubation time was 3 h. Length of stay in the intensive care unit was 2 days, whereas it was 4 days for hospital stay. One patient died during the procedure and six patients died after the procedure.
  
  
  CONCLUSIONS
  Percutaneous mitraclip implantation procedure is quite difficult for anaesthesiologists because of the procedure itself and the population on which the procedure is performed. The primary aim of anaesthesia management is to provide haemodynamic stability. The preoperative preparation and anaesthesia methods should be the same as for patients undergoing cardiac surgery. It is reported that as the experience regarding this subject increases, success of the procedure increases, with better protected haemodynamic stability, less inotropic and vasopressor requirement and shorter length of hospital stay.
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Ezgi
authors.initials: E
authors.lastname: Erkılıç
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Elvin
authors.initials: E
authors.lastname: Kesimci
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Döğer
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Tülin
authors.initials: T
authors.lastname: Gümüş
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Ellik
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Kanbak
keywords: Percutaneous mitraclip implantation; general anaesthesia; mitral regurgitation