Ultra-fast track anesthesia management for transcatheter mitral valve edge-to-edge repair
10.3969/j.issn.1004-8812.2024.05.003
- VernacularTitle:经导管二尖瓣缘对缘修复术的超快通道麻醉经验总结
- Author:
Zhi-Yao ZOU
1
;
Da ZHU
;
Yi-Ming CHEN
;
Shou-Zheng WANG
;
Jian-Bin GAO
;
Jing DONG
;
Xiang-Bin PAN
;
Ke YANG
Author Information
1. 云南省阜外心血管病医院昆明医科大学附属心血管医院麻醉科,昆明 650102
- Keywords:
Functional regurgitation;
Transcatheter edge-to-edge repair;
Anesthesia management;
Ultra-fast track anesthesia
- From:
Chinese Journal of Interventional Cardiology
2024;32(5):250-256
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively analyze the ultra-fast track anesthesia(UFTA)methods and perioperative anesthesia management experiences of transcatheter mitral valve edge-to-edge repair(TEER)in the treatment of functional mitral regurgitant.Methods In this retrospective study,patients underwent the TEER procedure and received UFTA in Fuwai Yunnan Hospital,from May 2022 to September 2022 for heart failure combined with moderate to severe or severe functional mitral regurgitant were included.Baseline,preoperative complications,cardial function and anesthesia classification,amino-terminal probrain natriuretic peptide(NT-proBNP),ultrasound examination results,surgery time,extubation time,intraoperative anesthetic and vasoactive drug,complications related to TEER and UFTA,perioperative,and postoperative 30-day and one-year follow-up data were collected.All perioperative clinical data were recorded and analyzed.Results A total of 30 patients were enrolled,11 patients(36.7％)were female,mean age was(63.6±6.1)years,NYHA classification IV 14 patients(46.7％),left ventricular ejection fraction(LVEF)(36.0±8.1)％,the end-diastolic volume of the left ventricle(66.0±8.2)mm,mitral regurgitation 4+14 patients(56.7％),3+17 patients(43.3％),NT-proBNP(1 934.1±1 973.5)pg/ml,1 patient(3.3％)used high-dose vasoactive drugs during surgery.All patients did not experience nausea,vomiting,delirium,respiratory depression,perioperative transesophageal echocardiography-related gastrointestinal bleeding,pericardial effusion,cerebrovascular accidents,emergency surgery or secondary intervention,or other serious adverse events within 24 hours after surgery.No 30-day all-cause death occurred;the mean postoperative hospital stay was(7.4±2.8)days.All patients completed one-year follow-up,LVEF(37.6±11.1)％,the end-diastolic volume of the left ventricle(63.2±8.6)mm,mitral regurgitation 2+7 patients(23.3％),1+23 patients(76.7％),NT-proBNP(1 949.2±2 576.6)pg/ml.Conclusions Ultra-fast track anesthesia can be safely applied to TEER in treating functional mitral regurgitant patients.
