TY - JOUR
T1 - Non-invasive ventilation-aided transoesophageal echocardiography in high-risk patients
T2 - A pilot study
AU - Guarracino, Fabio
AU - Cabrini, Luca
AU - Baldassarri, Rubia
AU - Cariello, Claudia
AU - Covello, Remo Daniel
AU - Landoni, Giovanni
AU - Petronio, Sonia
AU - Ambrosino, Nicolino
PY - 2010/7
Y1 - 2010/7
N2 - Aims Transoesophageal echocardiography (TEE) may require patient sedation, eventually leading to respiratory depression, a risky condition in severe cardiac disease. Non-invasive ventilation (NIV) has been applied during diagnostic manoeuvres, but its use during TEE has not been reported. We describe NIV-aided continuous TEE monitoring under sedation in the supine position in three consecutive orthopnoeic patients with severe aortic valve stenosis: two of them underwent percutaneous aortic valve implantation, and one underwent aortic valvuloplasty. Methods and results The TEE probe was passed through a hole performed with a surgical cutter in an NIV face-mask. Pulsoximetry, heart rate, arterial blood pressure, respiratory rate, arterial blood gases, patients' comfort, and patient's sedation were monitored throughout the procedure. Percutaneous aortic valve implantation procedures lasted almost 2 h, while the valvuloplasty procedure lasted 70 min. Non-invasive ventilation and continuous TEE were performed throughout the procedures without technical problems or respiratory or haemodynamic complications, and all patients felt always comfortable. Conclusion Non-invasive ventilation through a modified face-mask allowed to perform continuous TEE examination and to avoid tracheal intubation and general anaesthesia in three high-risk patients undergoing beating heart treatment of aortic valve stenosis.
AB - Aims Transoesophageal echocardiography (TEE) may require patient sedation, eventually leading to respiratory depression, a risky condition in severe cardiac disease. Non-invasive ventilation (NIV) has been applied during diagnostic manoeuvres, but its use during TEE has not been reported. We describe NIV-aided continuous TEE monitoring under sedation in the supine position in three consecutive orthopnoeic patients with severe aortic valve stenosis: two of them underwent percutaneous aortic valve implantation, and one underwent aortic valvuloplasty. Methods and results The TEE probe was passed through a hole performed with a surgical cutter in an NIV face-mask. Pulsoximetry, heart rate, arterial blood pressure, respiratory rate, arterial blood gases, patients' comfort, and patient's sedation were monitored throughout the procedure. Percutaneous aortic valve implantation procedures lasted almost 2 h, while the valvuloplasty procedure lasted 70 min. Non-invasive ventilation and continuous TEE were performed throughout the procedures without technical problems or respiratory or haemodynamic complications, and all patients felt always comfortable. Conclusion Non-invasive ventilation through a modified face-mask allowed to perform continuous TEE examination and to avoid tracheal intubation and general anaesthesia in three high-risk patients undergoing beating heart treatment of aortic valve stenosis.
KW - Aortic valve stenosis
KW - Implantation
KW - Non-invasive ventilation
KW - Percutaneous
KW - Transoesophageal echocardiography
KW - Valvuloplasty
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U2 - 10.1093/ejechocard/jeq019
DO - 10.1093/ejechocard/jeq019
M3 - Article
C2 - 20185524
AN - SCOPUS:77955864443
VL - 11
SP - 554
EP - 556
JO - European Journal of Echocardiography
JF - European Journal of Echocardiography
SN - 1525-2167
IS - 6
ER -