title: Influence of continuously evolving transcatheter aortic valve implantation technology on cerebral oxygenation.
abstract: This study assessed the influence of the evolution in Transcatheter Aortic Valve Implantation technology on cerebral oxygenation. Cerebral oxygenation was measured continuously with Near-Infrared Spectroscopy and compared retrospectively between balloon-expandable, self-expandable and differential deployment valves which were implanted in 12 (34%), 17 (49%) and 6 patients (17%), respectively. Left and right SctO2values were averaged at four time points and used for analysis (i.e. at baseline, balloon-aortic valvuloplasty, valve deployment, and at the end of the procedure). During balloon-aortic valvuloplasty and valve deployment, cerebral oxygenation decreased in patients treated with balloon or self-expandable valves (balloon-expandable: p = 0.003 and p = 0.002; self-expandable: p < 0.001 and p = 0.003, respectively). The incidence of cerebral desaturations below 80% of baseline was significantly larger in patients treated with balloon-expandable valves (p = 0.001). In contrast, patients who received differential deployment valves never experienced a cerebral desaturation below 80% of baseline. Furthermore, both the incidence and duration below a cerebral oxygenation of 55% was significantly different between balloon and self-expandable valves (p = 0.038 and p = 0.018, respectively). This study demonstrated that Transcatheter Aortic Valve Implantation procedures are associated with significant cerebral desaturations, especially during balloon-aortic valvuloplasty and valve deployment. Moreover, our results showed that latest innovations in Transcatheter Aortic Valve Implantation technology beneficially influenced the adequacy of cerebral perfusion.
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium. ward.eertmans@uhasselt.be.|Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. ward.eertmans@uhasselt.be.
authors.forename: Ward
authors.identifier: http://orcid.org/0000-0002-0052-7684
authors.initials: W
authors.lastname: Eertmans
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.|Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Genbrugge
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Fret
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Maud
authors.initials: M
authors.lastname: Beran
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Kim
authors.initials: K
authors.lastname: Engelen
authors.affiliation: Department of Cardiac Surgery, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Herbert
authors.initials: H
authors.lastname: Gutermann
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Margot
authors.initials: M
authors.lastname: Vander Laenen
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Willem
authors.initials: W
authors.lastname: Boer
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Ferdinande
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.|Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Jans
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.|Department of Cardiology, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.
authors.forename: Jo
authors.initials: J
authors.lastname: Dens
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium.|Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.
authors.forename: Cathy
authors.initials: C
authors.lastname: De Deyne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D063126:Balloon Valvuloplasty; D006328:Cardiac Catheterization; D002560:Cerebrovascular Circulation; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D010100:Oxygen / Q000032:analysis*; D010477:Perfusion; D012189:Retrospective Studies; D019265:Spectroscopy, Near-Infrared; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D010100:Oxygen
keywords: Evolution in valve technology; Near-infrared spectroscopy; Rapid ventricular pacing; Transcatheter Aortic Valve Implantation