Turkish Journal of Anaesthesiology & Reanimation
Cardiovascular and Thoracic Anaesthesia - ORIGINAL ARTICLE

Point-of-Care Ultrasound Before and After Transfemoral Transcatheter Aortic Valve Implantation

1.

Department of Anaesthesiology, Albany Medical Center, Albany, USA

Turk J Anaesthesiol Reanim 2020; 48: 491-496
DOI: 10.5152/TJAR.2020.08
Read: 32 Downloads: 13 Published: 22 May 2020

Objective: Surgical aortic valve replacement requires a comprehensive transoesophageal echocardiography (TEE) assessment before and after the intervention by cardiac anaesthesiologists. For patients undergoing transfemoral transcatheter aortic valve implantation (TF-TAVI), TEE is not routinely used. We started using transthoracic echocardiography (TTE) as a diagnostic and monitoring modality during TF-TAVI procedures. The aim of this study is to examine the usefulness of TTE before and after TF-TAVI. We hypothesised that TTE can serve as a screening tool in TF-TAVI patients and help rule out significant paravalvular leaks (PVLs), and serve as a monitoring tool.

 

Methods: A retrospective, observational study of 24 patients who underwent TF-TAVI with perioperative TTE over a 3-month period was conducted. Intraoperatively, two TTE examinations were performed. The first was a baseline pre-procedural TTE examination after anaesthetic induction, and the second was performed after TAVI valve implantation. Both pre- and post-procedural examinations included five focused TTE views. PVLs were graded as none, non-significant (trace or mild) or significant (moderate or severe).

 

Results: The average age and median body mass index of the patients were 82 years and 28.5 kg m-2, respectively. The average time recorded for the pre- and post-TAVI TTE examinations were approximately 4 and 5.5 min, respectively. Non-significant PVL was detected in 6 (25%) patients, and no leak was detected in 18 (75%) patients.

 

Conclusion: A focused TTE examination was found to be a useful adjunct during TF-TAVI for a cardiac anaesthesiologist in the absence of TEE, and useful in ruling out significant PVLs.

 

Cite this article as: Musuku SR, Cherukupalli D, Di Capua C, Fitzpatrick M, Sirigaddi K, Bughrara N, et al. Point-of-Care Ultrasound Before and After Transfemoral Transcatheter Aortic Valve Implantation. Turk J Anaesthesiol Reanim 2020; 48(6): 491-6.

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