Evaluation of the Factors Affecting the Length of Stay in Hospital of Transcatheter Aortic Valve Implantation (TAVI) Cases

Yıl 2021, Cilt: 5 Sayı: 1, 22 - 29, 26.02.2021

Sibel Büyükçoban Leyla İyilikçi

https://doi.org/10.30621/jbachs.857712

Cited By: 1

Öz

Introduction: In the treatment of inoperable patients with severe aortic stenosis or at high surgical risk, transcatheter aortic valve implantation (TAVI) is applied as an alternative to surgical aortic valve replacement. In our study, it was aimed to evaluate the factors affecting the length of stay in hospital of TAVI cases.
Method: After obtaining the approval of the ethics committee, the patients who received TAVI between 09.06.2012-19.01.2018 in the Interventional Cardiology unit of Dokuz Eylül University were retrospectively screened. A total of 243 patients were included in the study. Demographic data, preoperative accompanying diseases and echocardiographic results of the cases, the type of anesthesia applied, the duration of postoperative coronary intensive care, and a hospital stay were recorded. The analysis of the data was carried out in the SPSS 22.0 statistical package program,
Results: 53.5% of the patients who underwent transcatheter aortic valve implantation received general anesthesia, 46.5% received local anesthesia and sedation. 93.8% of the patients were discharged upon recovery. There was a significant difference between the postoperative length of stay in the hospital and the type of anesthesia (p=0.008). It was shown that patients who underwent general anesthesia were discharged later than patients who underwent sedation.
Discussion and Conclusion: Due to the high risks of surgery, it is of vital importance to shorten the length of stay in hospital in high-risk patients over 65 years of age who undergo TAVI.

Anahtar Kelimeler

TAVI, Sedation, general anesthesia, length of stay in hospital

Kaynakça

• KAYNAKLAR 1.Bahar A., Parlar S, Yaşlılık ve Evde Bakım. Fırat sağlık Hizmetleri Dergisi, 2007; 2(4):32-39.
• 2.E.R. Bates. Treatment options in severe aortic stenosis.Circulation, 124;2011:355-59.
• 3.V.T. Nkomo, J.M.Gardin , T.N. Skelton, J.S. Gottdiener, C.G. Scott, Enriquez-Sarrono. Burden of valvular heart diseases:a population -based study. Lancet,368;2006:1005-11
• 4.Vymazal T. Minimally invasive approach to calcified aortic valve replacement: Anaesthetic considerations. Indi Indian J Anaesth 2015;59:338–41.
• 5.Covello RD, Ruggeri L, Landoni G, Guarracino F, Bignami E, Gonfalini M, et al. Transcatheter implantation of an aortic valve: anesthesiological management. Minerva Anestesiol 2010;76:100–8.
• 6.Vahanian A, Alfieri O, Al-Attar N et al. Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS), the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2008;29:1463–1470(crossref)
• 7.Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Barwolf C, Levang OW, Tornos P, Vanoverschelde JL, Vermeer F, Boersma E, Ravaud P, Vahanian A (2003) A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. Eur Heart J 24:1231–1243 (crossref)
• 8.Iung B, Cachier A, Baron G et al Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J 2005;26:2714–2720(crossref)
• 9.Conradi L, Seiffert M, Franzen O, Baldus S, Schirmer J, Meinertz T, Reichenspurner H, Treede H (2011) First experience with transcatheter aortic valve implantation, concomitant percutaneous coronary intervention. Clin Res Cardiol 100:311–316(crossref)
• 10.Cribier A, Eltchaninoff H, Bash A et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case descrip- tion. Circulation 2002; 106: 3006-8. )
• 11.Rex S. Anesthesia for transcatheter aortic valve implantation: an update. Curr Opin Anaesthesiol 2013;26:456–66. [CrossRef ]
• 12.Petronio AS, Giannini C, De Carlo M, Bedogni F, Colombo A, Tamburino C, et al. Anaesthetic management of transcatheter aortic valve implantation: results from the Italian CoreValve registry. EuroIntervention 2016;12:381–8. [CrossRef ]
• 13.Chou WH, Wang YC, Huang HH, Cheng HL, Lin YS, Wang MJ, et al. Transcatheter aortic valve implantation: Anesthetic experience of retrograde transfemoral approach with CoreValve ReValving System. Acta Anaesthesiol Taiwan 2014;52:2–5. [CrossRef ]
• 14.Bonow RO, Leon MB, Doshi D, Moat N. Management strategies and futurechallenges for aortic valve disease. Lancet (London, England). 2016;387(10025):1312–23.2.
• 15.Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, Tuzcu EM,Webb JG, Fontana GP, Makkar RR, et al. Transcatheter aortic-valveimplantation for aortic stenosis in patients who cannot undergo surgery. NEngl J Med. 2010;363(17):1597–607.
• 16.He W., Goodkind D., Kowal P.: An aging world.2015. Washington, DC. January 3, 2019
• 17.Wohlgemut J.M., Ramsay G., Jansen J.O.: The changing face of emergency general surgery.Ann Surg 2018
• 18.Frohlich GM, Baxter PD, Malkin CJ, Scott DJ, Moat NE, Hildick‐Smith D et al . Comparative survival after transapical, direct aortic, and subclavian transcatheter aortic valve implantation (data from the Uk TAVI registry). Am J Cardiol 2015; 116: 1555– 9.
• 19.Contemporary review of severe aortic stenosis.Adams HSL, Ashokkumar S, Newcomb A, MacIsaac AI, Whitbourn RJ, Palmer S.Intern Med J. 2019 Mar;49(3):297-305. doi: 10.1111/imj.14071.PMID: 30091235 Review
• 20.Erdost Aksu H, İyilikçi L, Duru SL et al. Experiences of transcatheter aortic valve ımplantation with sevre aortic stenosis. Haydarpasa Numune Med J 2020;60(29173-77.
• 21.Agarwal, A. Rajamanickam, N.S. Bajaj, et al.Impact of aortic stenosis on postoperative outcomes after noncardiac surgeries.Circ Cardiovasc Qual Outcomes, 6 (2013), pp. 193-200
• 22.Tashiro, S.V. Pislaru, J.M. Blustin, et al.Perioperative risk of major non-cardiac surgery in patients with severe aortic stenosis: a reappraisal in contemporary practiceEur Heart J, 35 (2014), pp. 2372-2381
• 23.Transcatheter aortic valve implantation in the United States: Predictors of early hospital discharge J Interven Cardiol. 2017;30:149–155.
• 24. Barbanti M, Capranzano P, Ohno Y, et al. Early discharge after transfemoral transcatheter aortic valve implantation. Heart. 2015;101:1485–1490.
• 25. Durand E, Eltchaninoff H, Canville A, et al. Feasibility and safety of early discharge after transfemoral transcatheter aortic valve implan- tation with the Edwards SAPIEN-XT prosthesis. Am J Cardiol. 2015;115:1116–1122.
• 26.Ruggeri L, Gerli C, Franco A, Barile L, Magnano di San Lio MS, Villari N, et al. Anesthetic management for percutaneous aortic valve implantation: an overview of worldwide experiences. HSR Proc Intensive Care Cardiovasc Anesth 2012;4:40–6.
• 27.Shaw E,Gornila A,Piriz M et al.Multistate modelling to estimate excess length of stay and risk of death associated with organ/space infection after elective colorectal surgery. Journal of Hospital Infection.2018;100(4):400-05.
• 28.Influence of length of hospital stay on mortality after discharge in older patients with acute medical diseases].López Pardo P, Socorro García A, Baztán Cortés JJ.Gac Sanit. 2016 Sep-Oct;30(5):375-8.
• 29.Motloch LJ, Rottlaender D, Reda S. Et all. Local versus general anesthesia for transfemoral aortic valve implantation Clinical Research in Cardiology.2012;101:45-53
• 30.Dehedin B, Guinot PG, Ibrahim H et al.Aneshesia and perioperative management of patients who undergo transfemoral transcatheter aortic valve implantation: an observational study of general versuslocal/regional anesthesia in 125 consecutive patients. J Cardiothroc Vasc Anesth. 2011;(6):1036-43.
• 31.Franco A, Gerli C, Ruggeri L, Monaco F. Anesthetic management of transcatheter aortic valve implantation. Annals of Cardiac Anaesthesia 2012;15:54-63.
• 32.O’Connor ED, Walsham J (2009) Should we mobilise critically ill patients? A review. Crit Care Resusc 2009;11:290–300
• 33.Melidi E, Latsios G, Toutouzas K, Vavouranaki M, Tolios I, Gouliami M, et al. Cardio-anesthesiology considerations for the transcatheter aortic valve implantation (TAVI) procedure. Hellenic Society of Cardiyology 2016;57:401-6.