[Transcatheter aortic valve implantation : what do anesthetists need to know?]

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Surgical Innovation

Context:

• Aortic valve stenosis (AS) management faces challenges with aging populations and increased patient comorbidities.
• Conventional surgical aortic valve replacement (SAVR) carries significant risks for high-risk individuals.
• Minimally invasive techniques have evolved, leading to transcatheter aortic valve implantation (TAVI).

Purpose:

• To evaluate transcatheter aortic valve implantation (TAVI) as a therapeutic option for high-grade aortic valve stenosis.
• To highlight TAVI's suitability for patients with high perioperative risks associated with SAVR.
• To inform anesthetists about perioperative management and potential complications of TAVI.

Summary:

• Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement for severe aortic valve stenosis.
• TAVI is performed on a beating heart without sternotomy or cardiopulmonary bypass, making it ideal for elderly, multimorbid, or previously operated patients.
• Initial multicenter studies demonstrate TAVI's value in treating high-risk patients with symptomatic severe aortic valve stenosis.

Impact:

• TAVI expands treatment options for patients previously deemed inoperable or high-risk for SAVR.
• The procedure allows for potentially faster recovery and reduced morbidity in specific patient populations.
• Anesthesiologists require specialized knowledge for effective perioperative TAVI management and complication mitigation.