Anaesthetic management of percutaneous aortic valve implants: Results of 100 cases

Transfemoral transcatheter aortic-valve implantation represents a therapeutic alternative for patients with severe aortic stenosis who cannot undergo surgery due to high surgical risk.

The aim of this study is to describe the anaesthetic procedure for transfemoral transcatheter aortic-valve implantation and the results on 100 patients with symptomatic severe aortic stenosis.

A series of cases are presented with prospective data collected on 100 consecutive patients. The anaesthetic procedure consisted of continuous remifentanil and propofol infusions, for sedation or general anaesthetic.

Almost two-thirds (65%) of the cases ended on sedation, and 35% on general anaesthetic (19% out of this total were elective and 16% were due to complications during the procedure). Complications occurred in 34% of the cases, with both vascular and complete atrioventricular block being the most frequent. Mortality within the first 24h was 5%.

Implantation of transfemoral aortic prosthesis under remifentanil-propofol sedation can be considered a valid therapeutic alternative for patients with severe symptomatic aortic stenosis, and with a high surgical risk, and therefore not considered for conventional surgery.