Retrospective evaluation of patients undergoing transcatheter aortic valve implantation

Aim: The aim of this study is to establish a protocol for anesthesia applications during sedation-guided transcatheter aortic valve implantation (TAVI) by retrospectively analyzing the indications, procedural features, anesthesia drugs used, complications in the files and anesthesia reports of patients who underwent TAVI between 2017-2023 at Ondokuz Mayıs University Faculty of Medicine, Department of Anesthesiology and Reanimation. Patients and Methods: The operation data and anesthesia forms in the patients' files who underwent TAVI were reviewed retrospectively. Demographic data, accompanying comorbidities during treatment, imaging data, functional capacity, anesthetic drugs used, side effects, and complications were collected. Statistical evaluation was performed with the SPSS program. Results: Sapien XT valve was implanted in 57 patients, Evolut R valve was implanted in 85 patients, and Myval bioprosthesis TAVI valve was implanted in 62 patients. All patients were sedated, and mostly propofol and remifentanil infusions were used. In patients using Sapien XT valves, the need for noradrenaline and adrenaline during the procedure was found to be higher than other valves. In patients with Myval valves, the need for nitroglycerin during the procedure was found to be higher than other valves. Paravalvular leakage was the most common postoperative complication in all valve types and most commonly seen in patients with Evolut R valve placement. The need for a temporary pacemaker after the intervention was most common in patients who used Sapien XT valves. Conclusion: The first task of cardiology, cardiovascular surgery, and anesthesiologist team members is to make the proper patient selection. Although the choice of local anesthesia, sedation, and general anesthesia depends on the anesthesiologist's preference, an appropriate environment should be provided for all anesthesia methods. This study revealed that the valve types have different advantages, disadvantages, and complication rates. The complication rates may decrease with patient-specific valve selection, and prospective studies on these may contribute to these choices.