Unit:
Library of the School of Health SciencesΠΜΣ Μονάδες Εντατικής Θεραπείας και Καρδιολογική Νοσηλευτική
Author:
Kalantzis Charalampos
Supervisors info:
Εμμανουήλ Βαβουρανάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, ΕΠιβλέπων
Ελένη Κυρίτση, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Δημήτριος Τούσουλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Επίδραση της κολπικής μαρμαρυγής στα παροδικά σήματα υψηλής έντασης στη ροή των μέσων εγκεφαλικών αρτηριών κατά τη διάρκεια της διακαθετηριακής εμφύτευσης αορτικής βαλβίδας. Μελέτη με διακρανιακό Doppler.
Translated title:
Impact of atrial fibrillation on embolic high-intensity transient signals during TAVI. A transcranial Doppler study.
Summary:
Background: Embolic cerebrovascular events remain a major concern peri-operatively and following Transcatheter Aortic Valve Implantation (TAVI). We evaluated whether atrial fibrillation may predispose to an increased number of cerebrovascular emboli during the procedure.
Methods: Consecutive patients who underwent transfemoral TAVI with Evolut™ R bioprosthesis, were categorized into two groups. Group A patients with sinus rhythm, Group B patients with permanent atrial fibrillation on anticoagulation with Vitamin-K antagonists. The number of detected High Intensity Transient Signals (HITS) was assessed using Rimed Digi-Lite™ Transcranial Doppler on both cerebral arteries. The statistical analysis was conducted with the SPSS-22 statistic package and the statistics method used was x2-test and t-test. As statistically significant the level of 5% was considered significant.
Results: Twenty-four patients were recorded (81±8 years, 14 males (58.3%)). Group B had higher number of total HITS (775±103 vs. 610±123, p=0.002) as well as Phase I HITS (389±99 vs. 290±89, p=0.002) and Phase ΙΙ HITS (227±48 vs 182 ±40, p=0,021). One cerebrovascular event was recorded in Group B and one patient categorized to Group A developed major bleeding due to conversion to femoral surgical cut-down. The average number of received blood units, was higher in AF compared to SR Group (Group Α: 0,5±0,7 έναντι ομάδας Β: 0,8±1,9, p=0,886), without however, reaching statistical significance.
Conclusion: Patients with atrial fibrillation had larger burden of embolic HITS during TAVI indicating high risk patients for embolic cerebrovascular events. This may have implications for future strategies for cerebral embolic protection.
Main subject category:
Health Sciences
Keywords:
Severe aortic stenosis, TAVI, Αtrial fibrillation, Τranscranial Doppler, Stroke
Number of references:
159
