Anesthetic Management of Cardioband Implantation: Data From a Preliminary Experience and New Insights

M Pieri, Alessandro Belletti, Alessandro Oriani, G Landoni, A Latib, A Mangieri, A Colombo, A Zangrillo, F Monaco

Research output: Contribution to journalArticle

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Abstract

Objective Percutaneous procedures for the treatment of mitral valve disease represent valuable therapeutic options for high-risk patients. The anesthetic management of these patients is complex, as they often suffer from cardiac failure and present multiple comorbidities. A recently developed device for transcatheter mitral valve annuloplasty (Cardioband – Valtech Cardio, Or Yehuda, Israel) is now available in clinical practice. The aim of this study was to present the authors’ experience with Cardioband device implantation and to describe their anesthetic strategy. Design Retrospective study. Setting Cardiac catheterization laboratory of a teaching hospital. Participants Thirteen patients undergoing Cardioband implantation. Interventions All the procedures were performed under general anesthesia with continuous transesophageal echocardiographic monitoring. Three-dimensional echocardiography, inotropic therapy, cardiac pacing, and mechanical circulatory support always were available and performed as needed. Measurements and Main Results Mean age was 73±7.1 years, and mean preoperative ejection fraction was 38±7.4%. No complications related to anesthetic management were recorded. The authors observed 1 episode of device malfunction and 1 case of accidental damage to the circumflex artery. Postoperative complications were observed in 3 patients, involving detachment of the anchors, anemia requiring transfusions, vascular injury, and new-onset atrial fibrillation. Six patients (46%) required ICU admission. All patients (100%) were discharged from the hospital. Conclusions Cardioband device implantation under general anesthesia is a feasible approach when performed by skilled physicians with all the expertise and the resources of high-volume centers used to dealing with severely ill patients. © 2017 Elsevier Inc.
Original languageEnglish
Pages (from-to)482-488
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume31
Issue number2
DOIs
Publication statusPublished - 2017

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Anesthetics
Equipment and Supplies
General Anesthesia
Mitral Valve Annuloplasty
Three-Dimensional Echocardiography
Vascular System Injuries
Israel
Cardiac Catheterization
Mitral Valve
Teaching Hospitals
Atrial Fibrillation
Comorbidity
Anemia
Therapeutics
Heart Failure
Retrospective Studies
Arteries
Physicians

Cite this

Anesthetic Management of Cardioband Implantation: Data From a Preliminary Experience and New Insights. / Pieri, M; Belletti, Alessandro; Oriani, Alessandro; Landoni, G; Latib, A; Mangieri, A; Colombo, A; Zangrillo, A; Monaco, F.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 31, No. 2, 2017, p. 482-488.

Research output: Contribution to journalArticle

Pieri, M ; Belletti, Alessandro ; Oriani, Alessandro ; Landoni, G ; Latib, A ; Mangieri, A ; Colombo, A ; Zangrillo, A ; Monaco, F. / Anesthetic Management of Cardioband Implantation: Data From a Preliminary Experience and New Insights. In: Journal of Cardiothoracic and Vascular Anesthesia. 2017 ; Vol. 31, No. 2. pp. 482-488.
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abstract = "Objective Percutaneous procedures for the treatment of mitral valve disease represent valuable therapeutic options for high-risk patients. The anesthetic management of these patients is complex, as they often suffer from cardiac failure and present multiple comorbidities. A recently developed device for transcatheter mitral valve annuloplasty (Cardioband – Valtech Cardio, Or Yehuda, Israel) is now available in clinical practice. The aim of this study was to present the authors’ experience with Cardioband device implantation and to describe their anesthetic strategy. Design Retrospective study. Setting Cardiac catheterization laboratory of a teaching hospital. Participants Thirteen patients undergoing Cardioband implantation. Interventions All the procedures were performed under general anesthesia with continuous transesophageal echocardiographic monitoring. Three-dimensional echocardiography, inotropic therapy, cardiac pacing, and mechanical circulatory support always were available and performed as needed. Measurements and Main Results Mean age was 73±7.1 years, and mean preoperative ejection fraction was 38±7.4{\%}. No complications related to anesthetic management were recorded. The authors observed 1 episode of device malfunction and 1 case of accidental damage to the circumflex artery. Postoperative complications were observed in 3 patients, involving detachment of the anchors, anemia requiring transfusions, vascular injury, and new-onset atrial fibrillation. Six patients (46{\%}) required ICU admission. All patients (100{\%}) were discharged from the hospital. Conclusions Cardioband device implantation under general anesthesia is a feasible approach when performed by skilled physicians with all the expertise and the resources of high-volume centers used to dealing with severely ill patients. {\circledC} 2017 Elsevier Inc.",
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N2 - Objective Percutaneous procedures for the treatment of mitral valve disease represent valuable therapeutic options for high-risk patients. The anesthetic management of these patients is complex, as they often suffer from cardiac failure and present multiple comorbidities. A recently developed device for transcatheter mitral valve annuloplasty (Cardioband – Valtech Cardio, Or Yehuda, Israel) is now available in clinical practice. The aim of this study was to present the authors’ experience with Cardioband device implantation and to describe their anesthetic strategy. Design Retrospective study. Setting Cardiac catheterization laboratory of a teaching hospital. Participants Thirteen patients undergoing Cardioband implantation. Interventions All the procedures were performed under general anesthesia with continuous transesophageal echocardiographic monitoring. Three-dimensional echocardiography, inotropic therapy, cardiac pacing, and mechanical circulatory support always were available and performed as needed. Measurements and Main Results Mean age was 73±7.1 years, and mean preoperative ejection fraction was 38±7.4%. No complications related to anesthetic management were recorded. The authors observed 1 episode of device malfunction and 1 case of accidental damage to the circumflex artery. Postoperative complications were observed in 3 patients, involving detachment of the anchors, anemia requiring transfusions, vascular injury, and new-onset atrial fibrillation. Six patients (46%) required ICU admission. All patients (100%) were discharged from the hospital. Conclusions Cardioband device implantation under general anesthesia is a feasible approach when performed by skilled physicians with all the expertise and the resources of high-volume centers used to dealing with severely ill patients. © 2017 Elsevier Inc.

AB - Objective Percutaneous procedures for the treatment of mitral valve disease represent valuable therapeutic options for high-risk patients. The anesthetic management of these patients is complex, as they often suffer from cardiac failure and present multiple comorbidities. A recently developed device for transcatheter mitral valve annuloplasty (Cardioband – Valtech Cardio, Or Yehuda, Israel) is now available in clinical practice. The aim of this study was to present the authors’ experience with Cardioband device implantation and to describe their anesthetic strategy. Design Retrospective study. Setting Cardiac catheterization laboratory of a teaching hospital. Participants Thirteen patients undergoing Cardioband implantation. Interventions All the procedures were performed under general anesthesia with continuous transesophageal echocardiographic monitoring. Three-dimensional echocardiography, inotropic therapy, cardiac pacing, and mechanical circulatory support always were available and performed as needed. Measurements and Main Results Mean age was 73±7.1 years, and mean preoperative ejection fraction was 38±7.4%. No complications related to anesthetic management were recorded. The authors observed 1 episode of device malfunction and 1 case of accidental damage to the circumflex artery. Postoperative complications were observed in 3 patients, involving detachment of the anchors, anemia requiring transfusions, vascular injury, and new-onset atrial fibrillation. Six patients (46%) required ICU admission. All patients (100%) were discharged from the hospital. Conclusions Cardioband device implantation under general anesthesia is a feasible approach when performed by skilled physicians with all the expertise and the resources of high-volume centers used to dealing with severely ill patients. © 2017 Elsevier Inc.

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