Journal Article

Anaesthesia-related complications and side-effects in TAVI: a retrospective study in Germany

Wittmann, Sigrid, Sinner, Barbara, Goldfuss, Sophia, Holzamer, Andreas, Camboni, Daniele, Fischer, Marcus, Bitzinger, Diane, Würschinger, Fabian, Zausig, York Alexander, Seyfried, Timo

2019

Overview

ObjectivesThis study was performed to analyse anaesthesia-related complications and side effects in patients undergoing transcatheter aortic valve implantation (TAVI) under general anaesthesia.DesignRetrospective study.SettingThe study was performed as a single-centre study in a hospital of tertiary care in Germany.ParticipantsAll 853 patients, who underwent TAVI at the Universitätsklinikum Regensburg between January 2009 and July 2015, were included. 52.5% were female patients.Primary and secondary outcome measuresWe gathered information, such as recent illness, vital parameters and medication administered during the intervention and postoperatively for 12 hours. We analysed all anaesthesia-related complications and anaesthesia-related side effects that occurred during the intervention and entire hospital stay.ResultsWe analysed all 853 TAVI procedures. The mean patient age was 79 ± 6 years. In 99.5% of cases, we used volatile-based anaesthesia. 2.8% (n=24; transfemoral (TF): n=19 [3.8%]; transapical (TA): n=5 [1.4%]) of all cases suffered from anaesthesia-related complications. 819 (TF: n=447; TA: n=372) anaesthesia-related side effects occurred in 586 (68.7%, TF: n=325 [64.2%], TA: n=261 [75.2%]) patients. Neither the complications nor the side effects had any serious consequences. Intraoperative hypothermia in 44% of cases (TF: n=202 [39.9%]; TA: n=173 [49.9%]) and postoperative nausea and vomiting in 27% (n=232; TF: n=131 [25.9%], TA: n=101 [29.1%]) of cases were the most common anaesthesia-related side effects.ConclusionIn this study, serious anaesthesia-related complications were rarely seen, and non-critical anaesthesia-related side effects could have been avoided through consistent prophylaxis and management. Therefore, despite their high anaesthetic risk, general anaesthesia is justifiable in patients who underwent TAVI.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Aged / Aged, 80 and over / Anaesthesia / Anesthesia / Anesthesia, General - adverse effects / Blood pressure / Delirium / Female / Germany / Heart rate / Heart surgery / Hospitals / Humans / Intensive care / Intervention / Intraoperative Complications - etiology / Male / Mortality / Patients / Postoperative Complications - etiology / Retrospective Studies / Risk factors / Side effects / Systematic review / Transcatheter Aortic Valve Replacement