Could a "Simplified" Transcatheter Aortic Valve Replacement Procedure Eliminate Post-Operative Delirium?
نویسنده
چکیده
SEE PAGE 160 S ince the first human implants over a decade ago, transcatheter aortic valve replacement (TAVR) has evolved as the new standard of care for both inoperable and carefully selected highrisk patients with severe symptomatic aortic valve stenosis. Initial concerns with the rates of vascular injury, stroke, and residual paravalvular regurgitation have decreased. Current data suggest that device refinements and rigorous patient screening may further reduce some of these recognized complications with mid-term durability that is similar to surgically implanted valves. Post-operative delirium (POD) is a significant cause of cardiovascular morbidity and mortality after cardiac surgery with an incidence >30% in patients age >70 years (1–3). Compared with surgical revascularization alone, TAVR is associated with an added risk of POD (4–6). POD after cardiac surgery has been associated with prolonged mechanical ventilation (7,8), prolonged hospital length of stay, and increased shortand long-term mortality (8–11). Multiple nonpharmacological measures to predict and prevent POD have been documented in the published surgical data (12). Although few reports on the incidence and consequences of POD following TAVR are available (2,4,13), there is increasing interest in the potential ancillary benefits of a “simplified” transfemoral TAVR procedure with early mobilization and streamlined post-operative care (14–18).
منابع مشابه
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عنوان ژورنال:
- JACC. Cardiovascular interventions
دوره 9 2 شماره
صفحات -
تاریخ انتشار 2016