59例股动脉入路经导管主动脉瓣置换术的麻醉分析

Anesthesia Summary of 59 Cases of Transcatheter Aortic Valve Replacement via Femoral Artery

目的分析并总结四川省医学科学院·四川省人民医院开展经导管主动脉瓣置换术(TAVR)患者的麻醉管理经验。方法回顾性收集2020年1月至2021年12月在四川省医学科学院·四川省人民医院接受股动脉入路TAVR患者的病例资料,包括基本资料、麻醉方式、术中经食管超声心动图监测资料、麻醉监测和体温管理资料、永久起搏器置入情况以及院内转归。结果共纳入TAVR患者59例,围术期死亡6例(10.17%),瓣中瓣植入8例(13.56%),术后脑卒中1例(1.89%),术后永久起搏器置入8例(15.09%)。体温管理组35例,麻醉苏醒延迟2例;非体温管理组18例,麻醉苏醒延迟5例。结论严密的术中监测及术中体温管理可能在改善TAVR围手术期预后方面具有积极作用,并减少麻醉苏醒延迟。

Objective To analyze and summarize the anesthesia management experience of transcatheter aortic valve replacement(TAVR)in Sichuan Academy of Medical Sciences and Sichuan Provincial People's hospital.Methods The clinical data of patients who underwent TAVR via femoral artery approach in Sichuan Academy of Medical Sciences(also known as Sichuan Provincial People's Hospital)from January 2020 to December 2021 were retrospectively collected,including basic data,method of anesthesia,intraoperative transesophageal echocardiograghy,intraoperative anesthesia monitoring data,intraoperative body temperature management data,permanent pacemaker placement,and hospital outcome.Results A total of 59 cases of TAVR were included,including 6 cases of perioperative deaths(10.17%),8 cases of valve-in-valve implantation(13.56%),1 case of postoperative stroke(1.89%),and 8 cases of postoperative permanent pacemaker placement(15.09%).Delayed recovery from anesthesia occurred in 2 of the 35 patients with intraoperative temperature management,while it occurred in 5 of the 18 patients without intraoperative temperature management.Conclusion Strict intraoperative monitoring and intraoperative temperature management may play a positive role in the perioperative prognosis of TAVR and reduce the occurrence of delayed recovery from anesthesia.