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Awake transapical aortic valve implantation using thoracic epidural anesthesia
Chirojit Mukherjee1, Thomas Walther, Michael Andrew Borger
1Department of Anesthesiology, Heart Center Leipzig, University Leipzig, Leipzig, Germany. chirojit.mukherjee@med.uni-leipzig.de
The Annals of Thoracic Surgery
|August 25, 2009
Summary
Transapical aortic valve implantation can be performed awake using thoracic epidural anesthesia. This approach offers a safe alternative for patients with poor pulmonary function undergoing the minimally invasive procedure.
Area of Science:
- Cardiology
- Anesthesiology
- Minimally Invasive Surgery
Background:
- Transapical aortic valve implantation (TAVI) is a standard minimally invasive procedure for aortic valve stenosis.
- General anesthesia is typically required for TAVI, posing risks for patients with comorbidities.
- Alternative anesthetic techniques are needed to improve patient safety and outcomes.
Observation:
- An 85-year-old patient with significantly impaired pulmonary function was evaluated for TAVI.
- The patient's comorbidities precluded the use of general anesthesia.
- A novel anesthetic approach was considered to facilitate the procedure.
Findings:
- Successful transapical aortic valve implantation was achieved in the patient while awake.
- Thoracic epidural anesthesia was employed as the sole anesthetic modality.
- The patient tolerated the procedure well without major complications.
Implications:
- Awake TAVI using thoracic epidural anesthesia is feasible and safe for select patients.
- This technique may expand TAVI eligibility to high-risk individuals with pulmonary dysfunction.
- Thoracic epidural anesthesia represents a viable alternative to general anesthesia in TAVI.
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