Non-invasive ventilation-aided transoesophageal echocardiography in high-risk patients: A pilot study

Fabio Guarracino, Luca Cabrini, Rubia Baldassarri, Claudia Cariello, Remo Daniel Covello, Giovanni Landoni, Sonia Petronio, Nicolino Ambrosino

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)554-556
Number of pages3
JournalEuropean Journal of Echocardiography
Volume11
Issue number6
DOIs
Publication statusPublished - Jul 2010

Keywords

  • Aortic valve stenosis
  • Implantation
  • Non-invasive ventilation
  • Percutaneous
  • Transoesophageal echocardiography
  • Valvuloplasty

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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