Abstract:
AIM:Transcatheter aortic valve implantation (TAVI) is an emergent alternative technique to surgery in high-risk patients with aortic stenosis. Here, we describe the anesthesiological management of patients undergoing TAVI at our institution over an 18-month period. METHODS:After a proper assessment of surgical risk and comorbidities, 69 patients underwent TAVI with the transfemoral/subclavian approach. Both Edwards-Sapien and Corevalve prostheses were implanted. The anesthetic regimen consisted of general anesthesia or local anesthesia plus sedation. RESULTS:Twenty-seven patients received general anesthesia, and 42 received local anesthesia plus sedation. Procedural complications included prosthesis embolization (2), ascending aorta dissection (1), ventricular fibrillation following rapid ventricular pacing (8), vascular access site complications (17), and the valve-in-valve procedure (1). Three patients had to be converted from local anesthesia to general anesthesia (one patient had refractory ventricular fibrillation, and two patients were restless). All patients were alive at the 30-day follow-up. Mechanical ventilation time was 8.5+/-0.03 h. Mean ICU stay was 20.1+/-2.89 h. Postoperative complications included acute renal dysfunction (11), advanced atrioventricular block (9), and stroke (1). Thirty-six out of 42 (86%) patients were alive at the 6-month follow-up. CONCLUSIONS:TAVI is feasible in high-risk patients who would not be able to undergo surgical valve replacement. Hemodynamic management is the main concern of intraoperative anesthesiological management. General or local anesthesia plus sedation are both valid alternative techniques that can be titrated according to patient characteristics. Close postoperative monitoring in the ICU is required.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Covello RD,Ruggeri L,Landoni G,Guarracino F,Bignami E,Gonfalini M,Virzo I,Michev I,Colombo A,Zangrillo Asubject
Has Abstractpub_date
2010-02-01 00:00:00pages
100-8issue
2eissn
0375-9393issn
1827-1596pii
R02105747journal_volume
76pub_type
杂志文章abstract:BACKGROUND:Anaesthesia drugs cause the cutaneous vasodilatation that produces core temperature lowering at the beginning of general anaesthesia; when the thermal threshold for vasoconstriction is reached the cutaneous heat losses are decreased. Furthermore, the soda lime begins to produce water and heat after 40 minute...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-09-01 00:00:00
abstract::Results obtained with Althesin as anaesthetic in 100 patient subjected to urological surgery are presented. The continuous perfusion of Althesin gave a level of stable and flexible anaesthesia that, like the return to consciousness, was particularly appreciated by aged patients. Stress is laid on the fact that the har...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 评论,信件
doi:10.23736/S0375-9393.19.13553-5
更新日期:2019-07-01 00:00:00
abstract::Ziconotide is a synthetic peptide equivalent of an w-conotoxin, obtained from the marine snail Conus magus, which acts by blocking N-type calcium channels in the spinal cord, reducing the perception of pain. It is a newly marketed drug, exclusively for intrathecal use, indicated for severe chronic pain. Ziconotide cam...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2008-12-01 00:00:00
abstract::Inhalation agents represent a basic drug used in modern balanced anesthesia. In the present review, the pharmacokinetics, effectiveness and clinical effects of inhalation agents on different systems are discussed. Data concerning the metabolism and related toxicity of halogenated agents is reviewed, with particular re...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:The study aimed to compare Bispectral Index (BIS) and non-BIS anesthetic protocols on postoperative recovery outcomes. EVIDENCE ACQUISITION:Medline, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until January 21, 2016. EVIDENCE SYNTHESIS:Twenty-six studies were included with a tota...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.17.12033-X
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the use of laryngeal mask airway (LMA)® Protector™ by comparison with traditional LMA for performing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). METHODS:This was a retrospective observational single-center study including 143 patients w...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13328-7
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:The goal of the present work is to describe the development and results of the pediatric epidural analgesia program at the ''Hospital Nacional de Pediatria Prof. Dr. J. P. Garrahan'' in Argentina. METHODS:Patients with thoracotomy, abdominal surgery, osteotomy, amputations or severe trauma were included in ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2007-11-01 00:00:00
abstract::The influence of diazepam, the hemisuccinic ester of oxazepam, fentanyl and pentazocine on pain-producing sensation after surgery was tested in 160 patients subjected to ordinary and major surgery. Use was made of Dundee and Moore's modification of Clutton-Brock's test, and Bromage's test. Analysis of the results indi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::A case is presented of severe visceral leishmaniasis initially misdiagnosed owing to the old age of the patient and the contemporary presence of a carcinoma of the sigmoid. Admitted in ICU for severe post operative cardiorespiratory failure. During ICU stay the patients presented a bilateral pneumothorax and a long QT...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA syste...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:The characteristics of sevoflurane make it able to be used without N2O avoiding its undesirable effects to this associates. The aim of the study is to evaluate the clinical characteristics of sevoflurane anesthesia "N2O free" in comparison to sevoflurane anesthesia with N2O. METHODS:920 patient undergoing e...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:2000-09-01 00:00:00
abstract::Asthma and chronic obstructive pulmonary diseases (COPD) lead to functional obstruction of airways, identified by increased inspiratory and expiratory resistances. Increased expiratory resistances cause, in turn, a reduction in expiratory flow. The analysis of flow-volume loops shows that, as the disease progresses, t...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Numerous animal models have demonstrated neuronal damage resulting from anesthetic exposure in the developing brain. Studies have shown a relationship between anesthetic exposure and brain hypoxia, neurodegeneration and apoptosis. The relevance of data derived from controlled experimental studies to human ne...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:A wide variability in the approach towards delirium prevention and treatment in the critically ill results from the dearth of prospective randomised studies. METHODS:We launched a two-stage prospective observational study to assess delirium epidemiology, risk factors and impact on patient outcome, by enroll...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-09-01 00:00:00
abstract::Nutrition in critically ill patients should be considered as therapy: assessing the energy expenditure and the termogenic effect of food, and knowing the differences among composition and amount of given substrates, it is possible restore, maintain, or at least limit the derangement of energy equilibrium. Energy metab...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-06-01 00:00:00
abstract::Ahead of Print article withdrawn by publisher Blood brain barrier disruption (BBBD) is a novel technique for treating central nervous system lymphoma. This technique depends on the disruption of the tight junctions between endothelial cells (which represent the blood brain barrier) by intra-arterial injection of manni...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-10-21 00:00:00
abstract::Multiple sclerosis is a progressive demyelinating disease which affects large areas of the brain and of the spinal cord. Stressful events, surgical procedures, general anaesthesia and central blocks seem to be responsible for relapses, with worsening of the disease. So, when we scheduled 2 patients with multiple scler...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anesthetic versus conventional systemic analgesia. METHODS:Fift...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.18.12291-7
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Physical and mental workload during cardiopulmonary resuscitation (CPR) is challenging under extreme working conditions. We hypothesized that the mechanical chest-compression device Lund University Cardiac Assist System (LUCAS) increases the effectiveness of CPR, decreases the physical workload and improves ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Multiple patient and clinical characteristics contribute to the variable outcome of spinal anesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with h...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14138-5
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Predictive models of acute kidney injury after cardiac surgery (CS-AKI) include emergency surgery and patients with hemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the cas...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究
doi:10.23736/S0375-9393.18.12257-7
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:In an acute care setting, diuretics are often prescribed to maintain or increase urine output in patients presenting with acute kidney injury (AKI). The rationale behind giving diuretics is that they may protect the kidney from ischemic injury by maintaining a nonoliguric state. There have been many studies ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-05-01 00:00:00
abstract::The purpose of the case is to report the clinical value of the ultrasound-guided posterior approach to the brachial plexus in the treatment of phantom limb syndrome after an upper extremity amputation. The author experienced ultrasound guidance as sole technique to localize the brachial plexus for the purpose of placi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::Invasive candidiasis (IC) includes candidemia, disseminated candidiasis with deep organ involvement, endocarditis and meningitis. IC has an attributable mortality of 40% to 50% and is increasingly reported in intensive care units (ICUs). Candida albicans and non-albicans strains are both responsible for infections in ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Local anesthetics (LA) work by blocking sodium conductance through voltage-gated sodium channels. Complete local anesthetic resistance is infrequent, and the cause is unknown. Genetic variation in sodium channels is a potential mechanism for local anesthetic resistance. A patient with a history of inadequate...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2016-10-01 00:00:00
abstract::Postanaesthetic shivering is one of the leading causes of discomfort for patients recovering from general anesthesia. During EMG records, the distinguishing factor from shivering in fully awake patients is the existence of clonus similar to that recorded in patients with spinal cord transection. They coexist with the ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The detection of epidural space is usually performed by the technique of loss of resistance (LOR) without technological support, although there are few commercial options. In this work, we aimed to assess the feasibility of a new, non-invasive, mechatronic system for LOR detection in clinical settings. The s...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14031-8
更新日期:2020-07-01 00:00:00
abstract::A correct assessment of arterial pressure state during SAH is one of most critical issue in neurologic intensive care. It is important to evaluate two different clinical conditions: a) during SAH when the aneurysm is open, b) after aneurysmal clipping or embolization. The authors propose pressure parameters appropriat...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-05-01 00:00:00
abstract::The detection of tissue hypoxia and its correction is one of the aim of the hemodynamic monitoring. Classical hemodynamic variable often fail to achieve this goal. Lactate measurements may be a good indicator of tissue hypoxia. Selected review of the articles on lactate in critically ill patients. Tissue hypoxia is as...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-04-01 00:00:00