Evaluation of the Factors Affecting the Length of Stay in Hospital of Transcatheter Aortic Valve Implantation (TAVI) Cases

Abstract

INTRODUCTIONAccording to the population projections made by the Ministry of Health in 1996, it is estimated that the population aged 65 and over will be 12.1% in our country in 2030 (1). In the geriatric age group, systems work in balance under physiological conditions, with reduced organ and reserve capacity. Atrophic and fibrotic changes in the aging process also affect the aortic valve. Aortic stenosis (AS) is the most common valvular heart disease in adults over 65 (2). Moderate ABSTRACT Purpose: In the treatment of inoperable patients with severe aortic stenosis or at high surgical risk, transcatheter aortic valve implantation (TAVI) is applied as an alternative to surgical aortic valve replacement. In our study, it was aimed to evaluate the factors affecting the length of stay in hospital of TAVI cases. Method: After obtaining the approval of the ethics committee, the patients who received TAVI between 09.06.2012-19.01.2018 in the Interventional Cardiology unit of Dokuz Eylül University were retrospectively screened. A total of 243 patients were included in the study. Demographic data, preoperative accompanying diseases and echocardiographic results of the cases, the type of anesthesia applied, the duration of postoperative coronary intensive care and hospital stay of them were recorded. The analysis of the data was carried out in the SPSS 22.0 statistical package program, and the independent variables and their relationship with discharge were tested with chi-square analysis. Results: 53.5% of the patients who underwent transcatheter aortic valve implantation received general anesthesia, 46.5% received local anesthesia and sedation. 93.8% of the patients were discharged upon recovery. There was no significant difference between patients' gender, age, mitral insufficiency level, aortic insufficiency level, tricuspid insufficiency level, aortic valve area, and preoperative comorbid diseases and postoperative discharge time (p> 0.05). There was a significant difference between the postoperative length of stay in hospital and the type of anesthesia (p=0.008). It was shown that patients underwent general anesthesia were discharged later than patients underwent sedation. Conclusion: Due to the high risks of surgery, it is of vital importance to shorten the length of stay in hospital in high-risk patients over 65 years of age who undergo TAVI.

The effect of anesthesia management on mortality and morbidity in patients who underwent transcatheter aortic valve implantation

“…Although there was no difference between the groups in our study, hypertension was the most common comorbidity. This result was similar to many studies [14,15].…”

“…Büyükçoban et al [14] and Çakıer et al [15] reported the mean age of patients who underwent TAVI as 78.25±8.24 and 78.19±6.90, respectively. In our study, the mean age was 75.99±7.83 years and was consistent with the literature.…”